Opioid ketal compounds and uses thereof

ABSTRACT

This invention relates to opioid ketal compounds of Formula (I), Formula (II), or Formula (III): or a pharmaceutically acceptable salts thereof, wherein R1 is H or CH3, R2 is H or OH, n is 0, 1, 2 or 3, R3 and R4 are independently H or optionally substituted C1-C4 alkyl, or when n is 0, then R3 and R4 and the carbon atoms to which they are attached together form six, or seven membered ring, which is optionally mono or disubstituted by C1-C4 alkyl. The invention also relates to oxycodone ketal compounds of Formula (IV) or (V): or a pharmaceutically acceptable salts thereof. The invention also relates to the use of such compounds for the treatment, prevention, or amelioration of pain.

BACKGROUND OF THE INVENTION Field of the Invention

This invention is in the field of medicinal chemistry. In particular,the invention relates to novel opioid ketal compounds.

Related Art

The primary location of pain control is in the central nervous system(CNS). The three primary classes of opioid receptors, μ (mu), κ (kappa),and δ (delta), are distributed throughout the CNS and the periphery(Foss, J. F., The American Journal of Surgery 182 (Suppl. to November2001):19S-26S (2001)). The principal receptor involved in painmanagement is the p opioid receptor (Foss, J. F., ibid).

Opioids, also known as opioid agonists, are a group of compounds thatbind to the above mentioned opioid receptors, and exhibit opium ormorphine-like properties. The opioids are widely administered for avariety of medical indications but primarily they are employed asmoderate to strong analgesics. Examples of opioid compounds include, butare not limited to, morphine, oxycodone, hydromorphone, oxymorphone,hydrocodone, levophanol, methadone, meperidine, fentanyl, codeine,propoxyphene, buprenorphine, butorphanol, pentazocine and nalbuphine.

The use of opioid compounds has been reported to have a number ofpotential side effects, including abuse and diversion.

There have been attempts to reduce the abuse potential of opioids. Forexample, various opioid receptor antagonists have been developed toblock the action of opioid agonists when an overdose occurs. Also, in anattempt to formulate abuse-resistant tablets, various formulations havebeen developed containing an opioid receptor agonist combined with theopioid antagonist, wherein the antagonist becomes substantiallybioavailable upon crushing or tampering with the tablets.

Other alternatives to reduce the abuse potential of opioids include theuse of opioid prodrugs. Opioid prodrugs can exhibit differentpharmacological properties than opioids, such as those relating toabsorption, distribution, and elimination. For example, U.S. Pat. No.6,225,321 describes nalbuphine polyester derivatives; U.S. Pat. No.7,230,005 describes converting an opiate analgesic agent to its poorlyabsorbed ester prodrug or other prodrug derivatives; U.S. Patent Appl.Publication No. 2008/0318905 describes covalently attaching a prodrugmoiety to the amine functional group of an abuse-prone parent drug; andU.S. Patent Appl. Publication No. 2009/0192095 describes opioid prodrugscomprising an opioid analgesic covalently bonded through a carbamatelinkage to a peptide of 1-5 amino acids in length.

GB981046 and Lester et al., Tetrahedron 21:771-778 (1965), describeseveral opioid ketal compounds and the biological screening of anethylene ketal analog of oxycodone.

There remains a need in the art to provide improved opioid prodrugs thatprovide effective analgesia while reducing the potential for abuse oradverse side effects.

SUMMARY OF THE INVENTION

One embodiment of the present invention is directed to the novelcompounds represented by Formula I, Formula II, and Formula III, and thepharmaceutically acceptable salts thereof.

In another embodiment, the present invention is directed to novelcompounds represented by Formula IV and Formula V, and thepharmaceutically acceptable salts thereof.

In another embodiment, the present invention is directed to a mixture,comprising at least two stereoisomers of a compound of Formula I, or asalt thereof. In another embodiment, the present invention is directedto a mixture, comprising at least two isomers of a compound of FormulaIII, or a salt thereof. In another embodiment, the present invention isdirected to a mixture, comprising at least two isomers of a compound ofFormula IV, or a salt thereof. In another embodiment, the presentinvention is directed to a mixture, comprising at least two isomers of acompound of Formula V, or a salt thereof.

In another embodiment, the present invention is directed topharmaceutical compositions comprising a therapeutically effectiveamount of a compound of Formula I, Formula II, or Formula III, or apharmaceutically acceptable salt thereof, and a pharmaceuticallyacceptable carrier. In another embodiment, the present invention isdirected to pharmaceutical compositions comprising a therapeuticallyeffective amount of a mixture of at least two isomers of a compound ofFormula I or at least two isomers of a compound of Formula III, or thepharmaceutically acceptable salts thereof. In a particular embodiment,the pharmaceutical composition is an oral dosage form. In oneembodiment, the pharmaceutical composition is a solid oral dosage form.In another embodiment, the pharmaceutical composition is a liquid oraldosage form. In one embodiment, the dosage form is designed forimmediate release. In another embodiment, the dosage form is designedfor controlled release.

In another embodiment, the present invention is directed topharmaceutical compositions comprising a therapeutically effectiveamount of a compound of Formula IV or Formula V, or a pharmaceuticallyacceptable salt thereof, and a pharmaceutically acceptable carrier. Inanother embodiment, the present invention is directed to pharmaceuticalcompositions comprising a therapeutically effective amount of a mixtureof at least two isomers of a compound of Formula IV or at least twoisomers of a compound of Formula V, or the pharmaceutically acceptablesalts thereof, and a pharmaceutically acceptable carrier. In aparticular embodiment, the pharmaceutical composition is an oral dosageform. In one embodiment, the pharmaceutical composition is a solid oraldosage form. In another embodiment, the pharmaceutical composition is aliquid oral dosage form. In one embodiment, the dosage form is designedfor immediate release. In another embodiment, the dosage form isdesigned for controlled release.

In another embodiment, the present invention is directed to methods oftreating, ameliorating or preventing pain comprising administering acompound of Formula I, Formula II, or Formula III, or a pharmaceuticallyacceptable salt thereof, to a mammal in need of said treatment,amelioration or prevention. In another embodiment, the present inventionis directed to methods of treating, ameliorating or preventing paincomprising administering a compound of Formula IV or Formula V, or apharmaceutically acceptable salt thereof, to a mammal in need of saidtreatment, amelioration or prevention. In a particular embodiment, theadministration is by the oral route. In one embodiment, the compound isin a solid oral dosage form. In another embodiment, the compound is in aliquid oral dosage form. In one embodiment, the dosage form is designedfor immediate release. In another embodiment, the dosage form isdesigned for controlled release.

In another embodiment, the present invention is directed to methods oftreating, ameliorating or preventing pain comprising administering apharmaceutical composition of the invention to a mammal in need of saidtreatment, amelioration or prevention. In a particular embodiment, theadministration is by the oral route. In one embodiment, the compound isin a solid oral dosage form. In another embodiment, the compound is in aliquid oral dosage form. In one embodiment, the dosage form is designedfor immediate release. In another embodiment, the dosage form isdesigned for controlled release.

In another embodiment, the present invention is directed to a processfor preparing a compound of Formula I, Formula II, or Formula III, or asalt thereof. In another embodiment, the present invention is directedto a process for preparing a compound of Formula IV or Formula V, or asalt thereof.

In another embodiment, the present invention is directed to a compoundof Formula I, Formula II, or Formula III, or a pharmaceuticallyacceptable salt thereof, for use in the treatment, amelioration orprevention of pain. In another embodiment, the present invention isdirected to a compound of Formula IV or Formula V, or a pharmaceuticallyacceptable salt thereof, for use in the treatment, amelioration orprevention of pain.

In another embodiment, the present invention is directed to the use of acompound of Formula I, Formula II, or Formula III, or a salt thereof, inthe manufacture of a medicament for the treatment, amelioration orprevention of pain. In another embodiment, the present invention isdirected to the use of a compound of Formula IV or Formula V, or a saltthereof, in the manufacture of a medicament for the treatment,amelioration or prevention of pain.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the invention, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings are given by way of illustration only, and thusare not intended to limit the scope of the present invention.

FIG. 1 is a graph of the hydrolysis of a mixture of four isomers ofoxycodone 2,4-pentanediol ketal using Simulated Gastric Fluid (SGF)(0.2% NaCl and 0.32% pepsin in 0.084 N HCl) or 0.1 N HCl at 37° C. andthe release of oxycodone. The samples were analyzed by LCMS. Hydrolysisusing 0.1 N HCl simulates the acidic conditions within the humanstomach. Hydrolysis using SGF provides a comparison with 0.1 N HCl todetermine whether hydrolysis is affected by the presence of the pepsinenzyme.

FIG. 2 is a graph of the hydrolysis of a mixture of four isomers ofhydrocodone 2,4-pentanediol ketal using SGF or 0.1 N HCl at 37° C. andthe release of hydrocodone.

FIG. 3 is a graph of the hydrolysis of a mixture of four isomers ofhydromorphone 2,4 pentanediol ketal using 0.1 N HCl at 37° C., and therelease of hydromorphone.

FIG. 4 is a graph of the hydrolysis of a mixture of isomers of oxycodonecis 1,2-cyclohexancdimethanol ketals in 0.1 N HCl at 37° C., and therelease of oxycodone.

FIG. 5 is a graph of the hydrolysis of hydrocodone 1,3-propanediol ketalin 0.1 N HCl at 37° C. and the release of hydrocodone.

FIG. 6 is a graph of the hydrolysis of hydrocodone 2R,5R-hexanediolketal and hydrocodone 2S,5S-hexanediol ketal in 0.1 N HCl at 37° C. andthe release of hydrocodone.

FIG. 7 is the ¹H NMR (d6-DMSO) spectrum of the compound of Formula IV(oxycodone 2,4-pentanediol ketal).

FIG. 8 is the ¹H NMR (d6-DMSO) spectrum of the compound of Formula V(oxycodone 1,3-butanediol ketal).

FIG. 9 is a graph of the hydrolysis of a mixture of four isomers ofcompound of Formula IV (IVA-IVD) using 0.1 N HCl at 37° C. and therelease of oxycodone.

FIG. 10 is a graph of the hydrolysis of isomers IVC and IVD using 0.1 NHCl at 37° C. and the release of oxycodone.

FIG. 11 is a graph of the hydrolysis of a mixture of four isomers of thecompound of Formula V using 0.1 N HCl at 37° C., and the release ofoxycodone. The stereochemistry of each of the isomers of Formula Vremains to be assigned.

FIG. 12 is a graph of the hydrolysis of a mixture of four isomers of thecompound of Formula IV (IVA-IVD) in 5% acetic acid when heated to 100°C., which is intended to simulate “kitchen chemistry” conditions thatmay be used by a potential abuser, and the release of oxycodone.

FIG. 13 is a graph of the hydrolysis of a mixture of four isomers of thecompound of Formula V in 5% acetic acid at 100° C., and the release ofoxycodone.

FIG. 14 is a graph of the hydrolysis of a mixture of a number of isomersof oxycodone 3,5-octanediol ketals in 0.1 N HCl at 37° C., and therelease of oxycodone. The ketal isomers resolved into two differentpeaks under the LCMS conditions, and were tracked.

FIG. 15 is a graph of the hydrolysis of hydrocodone 2R,4R-pentanediolketal in buffers of different pHs at 37° C.

FIG. 16 is a graph of the hydrolysis of hydrocodone 2R,4R-pentanediolketal in buffers of different pHs at 37° C.

DETAILED DESCRIPTION OF THE INVENTION Definitions

As used herein, the term “isomer” is a general term for all isomers ofindividual molecules that differ only in the orientation of their atomsin space. It includes enantiomers and isomers of compounds with morethan one chiral center that are not mirror images of one another(diastereomers).

The term “chiral center” refers to a carbon atom to which four differentgroups are attached.

The terms “R configuration” and “S configuration” refer to theright-handed and left-handed configurations, respectively, at a stereocenter. The term “enantiomer” or “enantiomeric” refers to a moleculethat is non-superimposeable on its mirror image and hence opticallyactive wherein one enantiomer rotates the plane of polarized light inone direction and its mirror image enantiomer rotates the plane ofpolarized light in the opposite direction.

The term “racemic” refers to a mixture of equal parts of enantiomers andwhich, accordingly, is optically inactive.

The terms “resolution,” “resolve,” and the like, refer to theseparation, concentration or depletion of one of the two enantiomericforms of a molecule.

As used herein, the term “compound of Formula I” includes allstereoisomers, including enantiomers and diastereomers and mixtures ofenantiomers and diastereomers of compounds of Formula I, includingmixtures where one enantiomer or diastereomer is in excess of otherisomers in the mixture.

As used herein, the term “compound of Formula III” includes allstereoisomers, including enantiomers and diastereomers and mixtures ofenantiomers and diastereomers of compounds of Formula III, includingmixtures where one enantiomer or diastereomer is in excess of otherisomers in the mixture.

As used herein, the term “compound of Formula IV” includes isomers IVA,IVB, IVC, and IVD, all enantiomers and diastereomers and mixtures ofenantiomers and diastereomers of compounds of Formula IV, includingmixtures where one enantiomer or diastereomer is in excess of otherisomers in the mixture.

As used herein, the term “compound of Formula V” includes isomers VA,VB, VC, and VD, all enantiomers and diastereomers and mixtures ofenantiomers and diastereomers of compounds of Formula V, includingmixtures where one enantiomer or diastereomer is in excess of otherisomers in the mixture.

As used herein, the singular terms “a” and “the” are synonymous and usedinterchangeably with “one or more” and “at least one,” unless thelanguage and/or context clearly indicates otherwise. As used herein, theterm “comprising” means including, made up of, and composed of. Allnumbers in this description indicating amounts, ratios of materials,physical properties of materials, and/or use are to be understood asmodified by the word “about,” except as otherwise explicitly indicated.

The invention disclosed herein is also meant to encompass all salts ofthe disclosed compounds. The invention disclosed herein is also meant toencompass all pharmaceutically acceptable salts of the disclosedcompounds. Non-limiting examples of pharmaceutically acceptable saltsinclude inorganic and organic salts, such as chloride, bromide, iodide,phosphate, sulphate, citrate, lactate, tartrate, maleate, succinate,fumarate, mandelate, acetate, dichloroacetate, trifluoroacetate,oxalate, formate, carbonate, sulfonate, methanesulfonate,ethanesulfonate, benzenesulfonate, naphthalenesulfonate orp-toluenesulfonate. Unless otherwise indicated, all referenceshereinafter to compounds of Formula I, compound of Formula II, andcompounds of Formula III, are intended to include all pharmaceuticallyacceptable salts thereof. Unless otherwise indicated, all referenceshereinafter to compounds of Formula IV and compounds of Formula V,including one or more isomers IVA, IVB, IVC, IVD, VA, VB, VC and VD, areintended to include all pharmaceutically acceptable salts thereof.

As used herein, the term “delaying the onset” or “delayed onset” refersto the increased time to onset of therapeutic action post-administrationprovided by a compound of the present invention as compared to thecorresponding amount of the parent opioid during the same length of timevia the same route of administration.

As used herein, the terms “decrease the abuse potential,” “decreasedabuse potential,” and the like refer to the reduced potential of acompound of the invention for improper non-medical and/or recreationaladministration as compared to the parent opioid, yet wherein thecompound is still capable of delivering a therapeutically effectivedosage of the opioid when administered as directed.

Use of phrases such as “decreased,” “reduced,” “diminished,” or“lowered” in relation to abuse potential or overdose potential refer toat least about a 10% decrease in abuse potential or overdose potentialas measured by one or more standard measures of such abuse potential oroverdose as known in the art, with greater percentage changes beingpreferred for reduction in abuse potential and overdose potential. Forinstance, the decrease can be greater than 25%, 35%, 45%, 55%, 65%, 75%,85%, 95%, 96%, 97%, 98%, or 99%.

As used herein, the term “C₁-C₄ alkyl” as used by itself or as part ofanother group refers to a straight- or branched-chain aliphatichydrocarbon containing one to four, i.e. 1, 2, 3, or 4 carbon atoms orthe number of carbon atoms designated (i.e., a C₁ alkyl such as methyl,a C₂ alkyl such as ethyl, a C₃ alkyl such as propyl or isopropyl, etc.).In one embodiment, the alkyl group is chosen from a straight chain C₁₋₄alkyl group. In another embodiment, the alkyl group is chosen from abranched chain C₃₋₄ alkyl group. In another embodiment, the alkyl groupis chosen from a straight or branched chain C₃₋₄ alkyl group.Non-limiting exemplary C₁₋₄ alkyl groups include methyl, ethyl, propyl,isopropyl, butyl, sec-butyl, tert-butyl, and Iso-butyl. A preferred C₁₋₄alkyl group is methyl or ethyl.

As used herein, the term “optionally substituted C₁-C₄ alkyl” means thatthe alkyl as defined above is either unsubstituted or substituted withone, two, or three substituents independently chosen from halo (selectedfrom F, Cl, Br or I), hydroxy, cyano, nitro, C₁-C₄-alkoxy, amino,C₁-C₄-alkylamino, di-(C₁-C₄)-alkylamino, halo-C₁-C₄-alkoxy, carboxy,carboxy-C₁-C₄-alkyl, C₁-C₄-alkoxycarbonyl, and the like. In oneembodiment, the optionally substituted alkyl is substituted with twosubstituents. In another embodiment, the optionally substituted alkyl issubstituted with one substituent.

As used herein, the term “opioid” refers to a compound that binds to anopioid receptors, in particular to the μ (mu), κ (kappa), δ (delta) andORL1 receptor. Preferably, the opioids of the present application arebased on the morphinan or benzomorphan scaffold, i.e., derivatives ofmorphinan or benzomorphan scaffold. Examples of opioid compounds for usein the present application include, but are not limited to, morphine,oxycodone, hydromorphone, oxymorphone, hydrocodone, levorphanol,methadone, meperidine, fentanyl, codeine, propoxyphene, buprenorphine,butorphanol, pentazocine and nalbuphine. Preferably, the opioidcompounds for use in the present application are selected from morphine,oxycodone, hydromorphone, oxymorphone, hydrocodone, levorphanol,codeine, buprenorphine, butorphanol, pentazocine and nalbuphine.

As used herein, the term “opioid therapy” refers to administration of anopioid to a subject for treatment or prophylaxis.

Compounds of Formula I, Formula II, Formula III, Formula IV, and FormulaV

A compound of Formula I, Formula II, Formula III, Formula IV, or FormulaV of the invention is a ketal derivative of an opioid. The opioid can beoxycodone, hydrocodone, oxymorphone, or hydromorphone. Compounds ofFormula I, Formula II, Formula III, Formula IV, or Formula V reactdifferently based on routes of administration to a mammal. Compounds ofFormula I, Formula II, Formula III, Formula IV, and Formula V aredesigned to have low or no opioid activity when administered by aninappropriate route such as by parenteral administration (e.g.,injection) or by transmucosal administration (e.g., intranasal, buccal,sublingual, or inhalation). In contrast, appropriate administration bythe oral route of a compound of Formula I, Formula II, Formula III,Formula IV, or Formula V can result in effective opioid activity throughthe conversion of the opioid ketal derivative to the parent opioid byhydrolysis in the gastrointestinal (GI) tract. Therefore, compounds ofFormula I, Formula II, Formula III, Formula IV, or Formula V, whenadministered orally, are useful for treating, ameliorating or preventingany condition for which opioid administration is known to be useful,including pain, and especially chronic pain, in a mammal in needthereof, while reducing the potential for intentional abuse orunintentional misuse via an inappropriate route of administration.

Particular compounds of Formula I, Formula III, Formula IV, and FormulaV each have four possible isomers. Surprisingly, it has been found thatdifferent isomers of Formula I, Formula III, Formula IV and Formula Vhydrolyze at different rates. By preparing isomers of Formula I, FormulaIII, Formula IV and Formula V, and using selected ones, or by combiningtwo or more specific isomers in a mixture and adjusting and optimizingtheir relative ratios, a range of release rates and profiles of theparent opioid can be obtained. Accordingly, in one embodiment of theinvention, specific mixtures of isomers of compounds of Formula I,Formula III, Formula IV, or Formula V can be used to achieve a desiredrelease rate of the parent opioid in the mammal.

Compounds of Formula I have the following structural formula:

and include the pharmaceutically acceptable salts thereof, whereinR₁ is H or CH₃,R₂ is H or OH,n is 0, 1, 2 or 3,R₃ and R₄ are independently H or optionally substituted C₁-C₄ alkyl, orwhen n is 0, then R₃ and R₄ and the carbon atoms to which they areattached together form a five, six, or seven membered ring, which isoptionally mono- or di-substituted by independently selected C₁-C₄alkyl,and wherein the carbon atoms labeled * and ** are independently in the Ror S configuration.

In one embodiment, the compound of Formula I is hydrocodone2,4-pentanediol ketal or a pharmaceutically acceptable salt thereof,wherein R₁ is CH₃, R₂ is H, n is 1, and R₃ and R₄ are each CH₃. In oneembodiment, the hydrocodone 2,4-pentanediol ketal is a specificstereoisomer in which the carbon atom labeled * and the carbon atomlabeled ** are each independently in the R or S configuration. In oneembodiment, the invention is hydrocodone 2,4-pentanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Rconfiguration. In one embodiment, the invention is hydrocodone2,4-pentanediol ketal or a pharmaceutically acceptable salt thereof, inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the S configuration. In another embodiment, the invention ishydrocodone 2,4-pentanediol ketal or a pharmaceutically acceptable saltthereof, in which the carbon atom labeled * is in the R configurationand the carbon atom labeled ** is in the S configuration. In anotherembodiment, the invention is hydrocodone 2,4-pentanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * is in the S configuration and carbon atom labeled ** is in theR configuration.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of hydrocodone 2,4-pentanediol ketal, or pharmaceuticallyacceptable salts thereof. In one embodiment, the mixture comprises twoor more stereoisomers of hydrocodone 2,4-pentanediol ketal, orpharmaceutically acceptable salts thereof, wherein the stereoisomers arecompounds in which the carbon atom labeled * and the carbon atom labeled** are each independently in the R or S configuration. In anotherembodiment, the invention is a mixture of stereoisomers of hydrocodone2,4-pentanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the R configuration. In anotherembodiment, the invention is a mixture of stereoisomers of hydrocodone2,4-pentanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of a compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the S configuration.

In one embodiment, the compound of Formula I is oxycodone 2,5-hexanediolketal or a pharmaceutically acceptable salt thereof, wherein R₁ is CH₃,R₂ is OH, n is 2, and R₃ and R₄ are each CH₃. In one embodiment, theoxycodone 2,5-hexanediol ketal is a specific stereoisomer in which thecarbon atom labeled * and the carbon atom labeled ** are eachindependently in the R or S configuration. In one embodiment, theinvention is oxycodone 2,5-hexanediol ketal or a pharmaceuticallyacceptable salt thereof, in which the carbon atom labeled * and thecarbon atom labeled ** are both in the R configuration. In oneembodiment, the invention is oxycodone 2,5-hexanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Sconfiguration. In another embodiment, the invention is oxycodone2,5-hexanediol ketal or a pharmaceutically acceptable salt thereof, inwhich the carbon atom labeled * is in the R configuration and the carbonatom labeled ** is in the S configuration. In another embodiment, theinvention is oxycodone 2,5-hexanediol ketal or a pharmaceuticallyacceptable salt thereof, in which the carbon atom labeled * is in the Sconfiguration and the carbon atom labeled ** is in the R configuration.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of oxycodone 2,5-hexanediol ketal, or pharmaceuticallyacceptable salts thereof. In one embodiment, the mixture comprises twoor more stereoisomers of oxycodone 2,5-hexanediol ketal orpharmaceutically acceptable salts thereof, wherein the stereoisomers arecompounds in which the carbon atom labeled * and the carbon atom labeled** are each independently in the R or S configuration. In anotherembodiment, the invention is a mixture of stereoisomers of oxycodone2,5-hexanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of a compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the R configuration. In anotherembodiment, the invention is a mixture of stereoisomers of oxycodone2,5-hexanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of a compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the S configuration.

In one embodiment, the compound of Formula I is hydrocodone2,5-hexanediol ketal or a pharmaceutically acceptable salt thereof,wherein R₁ is CH₃, R₂ is H, n is 2, and R₃ and R₄ are each CH₃. In oneembodiment, the hydrocodone 2,5-hexanediol ketal is a specificstereoisomer in which the carbon atom labeled * and the carbon atomlabeled ** are each independently in the R or S configuration. In oneembodiment, the invention is hydrocodone 2,5-hexanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Rconfiguration. In one embodiment, the invention is hydrocodone2,5-hexanediol ketal or a pharmaceutically acceptable salt thereof, inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the S configuration. In another embodiment, the invention ishydrocodone 2,5-hexanediol ketal or a pharmaceutically acceptable saltthereof, in which the carbon atom labeled * is in the R configurationand the carbon atom labeled ** is in the S configuration. In anotherembodiment, the invention is hydrocodone 2,5-hexanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * is in the S configuration and carbon atom labeled ** is in theR configuration.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of hydrocodone 2,5-hexanediol ketal, or a salt thereof. Inone embodiment, the mixture comprises two or more stereoisomers ofhydrocodone 2,5-hexanediol ketal or pharmaceutically acceptable saltsthereof, wherein the stereoisomers are compounds in which the carbonatom labeled * and the carbon atom labeled ** are each independently inthe R or S configuration. In another embodiment, the invention is amixture of stereoisomers of hydrocodone 2,5-hexanediol ketal orpharmaceutically acceptable salts thereof, comprising an excess of acompound wherein the carbon atom labeled * and the carbon atom labeled** are both in the R configuration. In another embodiment, the inventionis a mixture of stereoisomers of hydrocodone 2,5-hexanediol ketal orpharmaceutically acceptable salts thereof, comprising an excess of acompound wherein the carbon atom labeled * and the carbon atom labeled** are both in the S configuration.

In one embodiment, the compound of Formula I is hydromorphone2,4-pentanediol ketal or a pharmaceutically acceptable salt thereof,wherein R₁ is H, R₂ is H, n is 1, and R₃ and R₄ are each CH₃. In oneembodiment, the hydromorphone 2,4-pentanediol ketal is a specificstereoisomer in which the carbon atom labeled * and the carbon atomlabeled ** are each independently in the R or S configuration. In oneembodiment, the invention is hydromorphone 2,4-pentanediol ketal or apharmaceutically acceptable salt thereof, in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Rconfiguration. In one embodiment, the invention is hydromorphone2,4-pentanediol ketal or a pharmaceutically acceptable salt thereof, inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the S configuration. In another embodiment, the invention ishydromorphone 2,4-pentanediol ketal or a pharmaceutically acceptablesalt thereof, in which the carbon atom labeled * is in the Rconfiguration and the carbon atom labeled ** is in the S configuration.In another embodiment, the invention is hydromorphone 2,4-pentanediolketal or a pharmaceutically acceptable salt thereof, in which the carbonatom labeled * is in the S configuration and carbon atom labeled ** isin the R configuration.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of hydromorphone 2,4-pentanediol ketal, orpharmaceutically acceptable salts thereof. In one embodiment, themixture comprises two or more stereoisomers of hydromorphone2,4-pentanediol ketal or pharmaceutically acceptable salts thereof,wherein the stereoisomers are compounds in which the carbon atomlabeled * and the carbon atom labeled ** are each independently in the Ror S configuration. In another embodiment, the invention is a mixture ofstereoisomers of hydromorphone 2,4-pentanediol ketal or pharmaceuticallyacceptable salts thereof, comprising an excess of a compound wherein thecarbon atom labeled * and the carbon atom labeled ** are both in the Rconfiguration. In another embodiment, the invention is a mixture ofstereoisomers of hydromorphone 2,4-pentanediol ketal or pharmaceuticallyacceptable salts thereof, comprising an excess of a compound wherein thecarbon atom labeled * and the carbon atom labeled ** are both in the Sconfiguration.

In one embodiment, the compound of Formula I is oxycodone1,2-cyclohexanediol ketal, or a pharmaceutically acceptable saltthereof, wherein R₁ is CH₃, R₂ is H, n is 0, and R₃ and R₄ together withthe carbon atoms to which they are attached form a six membered carbonring. In one embodiment, the oxycodone 1,2-cyclohexanediol ketal orpharmaceutically acceptable salts thereof, is a mixture of stereoisomersin which the carbon atom labeled * and the carbon atom labeled ** are inthe cis configuration relative to each other.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of oxycodone 1,2-cyclohexanediol ketal, orpharmaceutically acceptable salts thereof. In one embodiment, themixture comprises an excess of cis isomers of oxycodone1,2-cyclohexanediol ketal or a pharmaceutically acceptable salt thereof.

In one embodiment, the compound of Formula I is oxycodone 3,5-octanediolketal or a pharmaceutically acceptable salt thereof, wherein R₁ is CH₃,R₂ is OH, n is 1, and R₃ and R₄ are independently —CH₂CH₃ and CH₂CH₂CH₃.In one embodiment, the invention is a mixture, comprising two or morestereoisomers of oxycodone 3,5-octanediol ketal, or pharmaceuticallyacceptable salts thereof. In one embodiment, the mixture comprises twoor more stereoisomers of oxycodone 3,5-octanediol ketal orpharmaceutically acceptable salts thereof, wherein the stereoisomers arecompounds in which the carbon atom labeled * and the carbon atom labeled** are each independently in the R or S configuration. In anotherembodiment, the invention is a mixture of stereoisomers of oxycodone3,5-octanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of a compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the R configuration. In anotherembodiment, the invention is a mixture of stereoisomers of oxycodone3,5-octanediol ketal or pharmaceutically acceptable salts thereof,comprising an excess of a compound wherein the carbon atom labeled * andthe carbon atom labeled ** are both in the S configuration.

Other exemplary compounds of Formula I are:

In one embodiment, the compound of Formula I is an oxymorphone ketal, ora pharmaceutically acceptable salt thereof, wherein R₁ is CH₃ and R₂ isOH. In some embodiments, the compound of Formula I is oxymorphoneethyleneglycol ketal; oxymorphone 1,3-propanediol ketal; oxymorphone1,2-propanediol ketal; oxymorphone 2,3-butanediol ketal; oxymorphone2,4-pentanediol ketal; oxymorphone 2,5-hexanediol ketal; oxymorphone1,2-cyclohexanediol ketal; or a pharmaceutically acceptable saltthereof. In another embodiment, the invention is a mixture, comprisingtwo or more stereoisomers of oxymorphone 1,2-propanediol ketal;oxymorphone 2,3-butanediol ketal; oxymorphone 2,4-pentanediol ketal;oxymorphone 2,5-hexanediol ketal; or a pharmaceutically acceptable saltthereof.

In a particular embodiment, the invention is a compound of Formula I ora pharmaceutically acceptable salt thereof, with the proviso that thecompound is not hydrocodone ethyleneglycol ketal; hydromorphoneethyleneglycol ketal; oxycodone ethyleneglycol ketal; hydrocodone1,3-propanediol ketal; oxycodone 1,3-propanediol ketal; hydromorphone1,3-propanediol ketal; or a pharmaceutically acceptable salt thereof. Inanother embodiment, the invention is a mixture comprising two or morestereoisomers of a compound of Formula I or pharmaceutically acceptablesalts thereof, with the proviso that the mixture is not a mixture ofstereoisomers of hydrocodone 2,3-butanediol ketal; oxycodone2,3-butanediol ketal; hydrocodone 2,3-butanediol ketal; orpharmaceutically acceptable salts thereof.

Compounds of the present invention are also compounds of Formula II orFormula III.

and the pharmaceutically acceptable salts thereof.

In one embodiment, the compound of Formula III, or pharmaceuticallyacceptable salt thereof, is a specific stereoisomer in which the carbonatom labeled * and the carbon atom labeled ** are in the cisconfiguration relative to each other. In one embodiment, the compound ofFormula III or pharmaceutically acceptable salt thereof, is a specificstereoisomer in which the carbon atom labeled * and the carbon atomlabeled ** are in the trans configuration relative to each other.

In one embodiment, the invention is a mixture, comprising two or morestereoisomers of a compound of Formula III, or pharmaceuticallyacceptable salts thereof. In one embodiment, the mixture comprises anexcess of the cis isomer of the compound of Formula III or apharmaceutically acceptable salt thereof. In another embodiment, themixture comprises an excess of the trans isomer of the compound ofFormula III or a pharmaceutically acceptable salt thereof.

In another embodiment, the invention includes compounds of Formula IV(oxycodone 2,4-pentanediol ketal) and Formula V (oxycodone1,3-butanediol ketal):

and the pharmaceutically acceptable salts thereof.

In one embodiment, the invention is an isomer of Formula IVA, IVB, IVCor IVD:

or a pharmaceutically acceptable salt thereof.

In one embodiment, the invention is a compound of Formula IV (oxycodone2,4-pentanediol ketal) or a pharmaceutically acceptable salt thereof.

In one embodiment, the compound is isomer IVA (oxycodone2R,4S-pentanediol ketal) or a pharmaceutically acceptable salt thereof.

In another embodiment, the compound is isomer IVB (oxycodone2S,4R-pentanediol ketal) or a pharmaceutically acceptable salt thereof.

In another embodiment, the compound is isomer IVC (oxycodone2S,4S-pentanediol ketal) or a pharmaceutically acceptable salt thereof.

In another embodiment, the compound is isomer IVD (oxycodone2R,4R-pentanediol ketal) or a pharmaceutically acceptable salt thereof.

In a particular embodiment, the invention is a mixture of isomers ofFormula IV or pharmaceutically acceptable salts thereof, comprising anexcess of a compound wherein the carbon atoms labeled * are both in theR configuration (oxycodone 2R,4R-pentanediol ketal). In anotherembodiment, the invention is a mixture of isomers of Formula IV orpharmaceutically acceptable salts thereof, comprising an excess of acompound wherein the carbon atoms labeled * are both in the Sconfiguration (oxycodone 2S,4S-pentanediol ketal).

In one embodiment, the invention is a mixture comprising at least twoisomers of a compound of Formula IV selected from the group consistingof IVA, IVB, IVC and IVD and the pharmaceutically acceptable saltsthereof.

In one embodiment, the mixture comprises isomers IVA and IVB or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVA and IVC or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVA and IVD or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVB and IVC or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVB and IVD or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVC and IVD or thepharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVC and IVD or thepharmaceutically acceptable salts thereof, wherein the isomer IVC or itssalt is present in an amount greater than isomer IVD or its salt.

In yet another embodiment, the mixture comprises isomers IVC and IVD orthe pharmaceutically acceptable salts thereof, wherein the isomer IVD orits salt is present in an amount greater than isomer IVC or its salt.

In one embodiment, the mixture comprises isomers IVA, IVB, IVC, and IVDor the pharmaceutically acceptable salts thereof.

In another embodiment, the mixture comprises isomers IVA, IVB, IVC, andIVD or the pharmaceutically acceptable salts thereof, wherein theisomers IVC and IVD, or the salts thereof, together are present in anamount greater than isomers IVA and IVB together or the salts thereof.

In another embodiment, the invention is a compound of Formula V(oxycodone 1,3-butanediol ketal).

In another embodiment, compounds of the present invention are isomers ofFormula VA, VB, VC or VD:

and the pharmaceutically acceptable salts thereof.

In one embodiment, the compound is isomer VA or a pharmaceuticallyacceptable salt thereof.

In another embodiment, the compound is isomer VB or a pharmaceuticallyacceptable salt thereof.

In another embodiment, the compound is isomer VC or a pharmaceuticallyacceptable salt thereof.

In another embodiment, the compound is isomer VD or a pharmaceuticallyacceptable salt thereof.

In one embodiment, the invention is a mixture, comprising at least twoisomers of a compound of Formula V selected from the group consisting ofVA, VB, VC and VD, or their pharmaceutically acceptable salts.

In one embodiment, the mixture comprises isomers VA and VB, or theirpharmaceutically acceptable salts.

In another embodiment, the mixture comprises isomers VA and VC, or theirpharmaceutically acceptable salts.

In another embodiment, the mixture comprises isomers VA and VD, or theirpharmaceutically acceptable salts.

In another embodiment, the mixture comprises isomers VB and VC, or theirpharmaceutically acceptable salts.

In another embodiment, the mixture comprises isomers VB and VD, or theirpharmaceutically acceptable salts.

In another embodiment, the mixture comprises isomers VC and VD, or theirpharmaceutically acceptable salts.

In one embodiment, the mixture comprises isomers VA, VB, VC and VD, ortheir pharmaceutically acceptable salts.

Methods of Preparation

Compounds of Formula I, Formula II, and Formula III can be preparedusing methods known to those skilled in the art in view of the presentdisclosure. For example, compounds of Formula I can be prepared as shownin Scheme 1 by reacting an opioid with a diol, optionally in thepresence of an acid catalyst and optionally in the presence of asolvent:

In one embodiment, hydrocodone is reacted with 2,4-pentanediol toprepare a mixture of stereoisomers of hydrocodone 2,4-pentanediol ketal.In another embodiment, hydrocodone is reacted with 2R,4R-pentanediol toprepare the hydrocodone 2,4-pentanediol ketal in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Rconfiguration. In another embodiment, hydrocodone is reacted with2S,4S-pentanediol to provide the hydrocodone 2,4-pentanediol ketal inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the S configuration. In yet another embodiment, a mixture of isomersis prepared by reacting hydrocodone with meso 2,4-pentanediol to producea mixture of stereoisomers of hydrocodone 2,4-pentanediol ketal, inwhich one stereoisomer is a compound wherein the carbon atom labeled *is in the R configuration and the carbon atom labeled ** is in the Sconfiguration, and the other stereoisomer is a compound wherein thecarbon atom labeled * is in the S configuration and the carbon atomlabeled ** is in the R configuration.

In one embodiment, oxycodone is reacted with 2,5-hexanediol to prepare amixture of stereoisomers of oxycodone 2,5-hexanediol ketal. In anotherembodiment, oxycodone is reacted with 2R,5R-hexanediol to prepare theoxycodone 2,5-hexanediol ketal in which the carbon atom labeled * andthe carbon atom labeled ** are both in the R configuration. In anotherembodiment, oxycodone is reacted with 2S,5S-hexanediol to provide theoxycodone 2,5-hexanediol ketal in which the carbon atom labeled * andthe carbon atom labeled ** are both in the S configuration. In yetanother embodiment, a mixture of isomers is prepared by reactingoxycodone with meso 2,5-hexanediol to produce a mixture of stereoisomersof oxycodone 2,5-hexanediol ketal, in which one stereoisomer is acompound wherein the carbon atom labeled * is in the R configuration andthe carbon atom labeled ** is in the S configuration, and the otherstereoisomer is a compound wherein the carbon atom labeled * is in the Sconfiguration and the carbon atom labeled ** is in the R configuration.

In one embodiment, hydrocodone is reacted with 2,5-hexanediol to preparea mixture of stereoisomers of hydrocodone 2,5-hexanediol ketal. Inanother embodiment, hydrocodone is reacted with 2R,5R-hexanediol toprepare the hydrocodone 2,5-hexanediol ketal in which the carbon atomlabeled * and the carbon atom labeled ** are both in the Rconfiguration. In another embodiment, hydrocodone is reacted with2S,5S-hexanediol to provide the hydrocodone 2,5-hexanediol ketal inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the S configuration. In yet another embodiment, a mixture of isomersis prepared by reacting hydrocodone with meso 2,5-hexanediol to producea mixture of stereoisomers of hydrocodone 2,5-hexanediol ketal in whichone stereoisomer is a compound wherein the carbon atom labeled * is inthe R configuration and the carbon atom labeled ** is in the Sconfiguration, and the other stereoisomer is a compound wherein thecarbon atom labeled * is in the S configuration and the carbon atomlabeled ** is in the R configuration.

In one embodiment, hydromorphone is reacted with 2,4-pentanediol toprepare a mixture of stereoisomers of hydromorphone 2,4-pentanediolketal. In another embodiment, hydromorphone is reacted with2R,4R-pentanediol to prepare the hydromorphone 2,4-pentanediol ketal inwhich the carbon atom labeled * and the carbon atom labeled ** are bothin the R configuration. In another embodiment, hydromorphone is reactedwith 2S,4S-pentanediol to provide the hydromorphone 2,4-pentanediolketal in which the carbon atom labeled * and the carbon atom labeled **are both in the S configuration. In yet another embodiment, a mixture ofisomers is prepared by reacting hydromorphone with meso 2,4-pentanediolto produce a mixture of stereoisomers of hydromorphone 2,4-pentanediolketal. in which one stereoisomer is a compound wherein the carbon atomlabeled * is in the R configuration and the carbon atom labeled ** is inthe S configuration, and the other stereoisomer is a compound whereinthe carbon atom labeled * is in the S configuration and the carbon atomlabeled ** is in the R configuration.

In one embodiment, oxycodone is reacted with 3,5-octanediol to prepare amixture of stereoisomers of oxycodone 3,5-octanediol ketal.

In one embodiment, oxycodone is reacted with 1,2-cyclohexanediol toprepare a mixture of stereoisomers of oxycodone 1,2-cyclohexanediolketal. In another embodiment, oxycodone is reacted withcis-1,2-cyclohexanediol to prepare the oxycodone cis-1,2-cyclohexanediolketal. In another embodiment, oxycodone is reacted withtrans-1,2-cyclohexanediol to provide the oxycodonetrans-1,2-cyclohexanediol ketal.

In another embodiment, an opioid such as oxycodone, hydrocodone, orhydromorphone is reacted with ethylene glycol or 1,2-propanediol toprepare the ethyleneglycol ketal or a mixture of stereoisomers of thepropanediol ketal, respectively.

A further embodiment of the present invention is a process for preparinga compound of Formula II, as shown in Scheme 2, comprising reactingoxycodone with 2,2-dimethyl-1,3-propanediol, optionally in the presenceof an acid catalyst and optionally in the presence of a solvent toproduce a compound of Formula II.

A further embodiment of the present invention is a process for preparinga compound of Formula III, as shown in Scheme 3, comprising reactingoxycodone with 1,2-cyclohexanedimethanol to prepare a mixture ofstereoisomers of oxycodone 1,2-cyclohexanedimethanol ketal. In anotherembodiment, oxycodone is reacted with cis-1,2-cyclohexanedimethanol toprepare the oxycodone cis-1,2-cyclohexanedimethanol ketal. In anotherembodiment, oxycodone is reacted with trans-1,2-cyclohexanedimethanol toprepare the oxycodone trans-1,2-cyclohexanedimethanol ketal.

In one embodiment, a mixture of at least two isomers of Formula I or amixture of at least two isomers of Formula III are resolved usingtechniques known in the art in view of this disclosure. Such techniquesinclude, but are not limited to chromatographic methods such as silicagel chromatography, reversed phase chromatography, ion-exchangechromatography, hydrophobic interaction chromatography, size exclusionchromatography, affinity chromatography, and combinations thereof, aswell as filtration methods and precipitation methods. In a particularembodiment, isomers of Formula I are resolved using preparative HPLC.

In another embodiment, compounds of Formula IV and Formula V can beprepared using methods known to those skilled in the art in view of thepresent disclosure. For example, compounds of Formula IV can be preparedby reacting oxycodone with 2,4-pentanediol, optionally in the presenceof an acid catalyst and optionally in the presence of a solvent toproduce a compound of Formula IV, as shown in Scheme 4:

In one embodiment, the reaction of oxycodone with 2,4-pentanediolresults in a mixture of isomers IVA, IVB, IVC, and IVD.

In one embodiment, isomer IVD can be prepared by reacting2R,4R-pentanediol with oxycodone, optionally in the presence of an acidcatalyst and optionally in the presence of a solvent to produce isomerIVD. In another embodiment, isomer IVC can be prepared by reactingoxycodone with 2S,4S-pentanediol, optionally in the presence of an acidcatalyst and optionally in the presence of a solvent to produce isomerIVC. In yet another embodiment, a mixture of isomers IVA and IVB can beprepared by reacting oxycodone with meso 2,4-pentanediol, optionally inthe presence of an acid catalyst and optionally in the presence of asolvent to produce a mixture of isomers IVA and IVB. In yet anotherembodiment, isomer IVA, IVB, IVC, or IVD can be prepared by resolving amixture of enantiomers or diastereomers using techniques commonly knownin the art in view of this disclosure.

A further embodiment of the present invention is a process for preparinga compound of Formula V comprising reacting oxycodone with1,3-butanediol, optionally in the presence of an acid catalyst andoptionally in the presence of a solvent to produce a compound of FormulaV (oxycodone 1,3-butanediol ketal) as shown in Scheme 5.

In one embodiment, isomers VA and VD can be prepared by reacting(R)-1,3-butanediol with oxycodone, optionally in the presence of an acidcatalyst and optionally in the presence of a solvent to produce isomersVA and VD. In one embodiment, isomers VB and VC can be prepared byreacting (S)-1,3-butanediol with oxycodone, optionally in the presenceof an acid catalyst and optionally in the presence of a solvent toproduce isomers VB and VC. In yet another embodiment, isomer VA, VB, VCor VD can be prepared by resolving a mixture of enantiomers ordiastereomers using techniques commonly known in the art in view of thisdisclosure.

In one embodiment, a mixture of at least two isomers of Formula IV or amixture of at least two isomers of Formula V are resolved usingtechniques known in the art in view of this disclosure. Such techniquesinclude, but are not limited to chromatographic methods such as silicagel chromatography, reversed phase chromatography, ion-exchangechromatography, hydrophobic interaction chromatography, size exclusionchromatography, affinity chromatography, and combinations thereof, aswell as filtration methods and precipitation methods. In a particularembodiment, isomers of Formula IV or isomers of Formula V are resolvedusing preparative HPLC.

In some non-limiting embodiments, the diols used to prepare compounds ofFormula I, Formula II, Formula III, Formula IV, or Formula V is obtainedcommercially. In some non-limiting embodiments, the diols used toprepare compounds of Formula I, Formula II, Formula III, Formula IV, orFormula V are prepared using methods commonly known to persons ofordinary skill in the art.

In some non-limiting embodiments, the compounds of Formula I, FormulaII, Formula III, Formula IV, or Formula V are converted to their saltsusing techniques commonly known to a person of ordinary skill in theart. In other embodiments, the salt is a pharmaceutically acceptablesalt.

In some non-limiting embodiments, the reaction to prepare compounds ofFormula I, Formula II, Formula III, Formula IV, or Formula V occurs in anon-polar solvent. In some non-limiting embodiments, the solvent ispentane, cyclopentane, hexane, cyclohexane, benzene, toluene, xylene,1,4-dioxane, chloroform, diethylether, dichloromethane, tetrahydrofuran,dimethyl sulfoxide, carbon tetrachloride, pyridine, dimethylfuran, or amixture thereof. In some embodiments, the solvent is toluene.

In some non-limiting embodiments, the acid catalyst used in the reactionto prepare compounds of Formula I, Formula II, Formula III, Formula IV,or Formula V is a sulfonic acid. In some embodiments, the acid catalystis methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid,naphthalenesulfonic acid, p-toluenesulfonic acid (“PTSA”),ethanedisulfonic acid, propanedisulfonic acid,naphthalene-1,5-disulfonic acid, or a mixture thereof. In someembodiments, the acid catalyst is PTSA.

In some non-limiting embodiments, the reaction to prepare compounds ofFormula I, Formula II, Formula III, Formula IV, or Formula V occurs withthe removal of water using azeotropic distillation. In some embodiments,the water is removed using molecular sieves or aluminum oxide.

In some non-limiting embodiments, the ratio of the acid catalyst to theopioid in the reaction on a molar basis is about 0.5:1, about 0.6:1,about 0.7:1, about 0.8:1, about 0.9:1, about 1:1, about 1.1:1, about1.2:1, about 1.3:1, about 1.4:1, about 1.5:1, about 1.6:1, about 1.7:1,about 1.8:1, about 1.9:1, about 2:1, about 2.5:1, about 3:1, about 4:1,or about 5:1. In some embodiments, the ratio of the acid catalyst to theoxycodone in the reaction ranges from about 1:1 to about 1.5:1. In someembodiments, the ratio of the acid catalyst to the oxycodone in thereaction is about 1.2:1.

In other embodiments, the ratio of the opioid to the diol in thereaction on a molar basis is about 1:1, about 1:1.05, about 1:1.1, about1:1.2, about 1:1.3, about 1:1.5, about 1:2, about 1:2.5, about 1:3,about 1:4, about 1:5, about 1:10, about 1:20, about 1:30, about 1:40,about 1:50, or about 1:100.

In other embodiments, the reaction to prepare compounds of the inventionis carried out under conditions of refluxing toluene. In one embodiment,the reaction is carried out under refluxing xylene. In anotherembodiment, the reaction is carried out at about 70° C., about 80° C.,about 90° C., about 100° C., about 110° C., about 120° C., or about 130°C.

In another embodiment, the reaction is carried out for a time period offrom about 3 hours to about 24 hours. In a particular embodiment, thereaction is carried out for about 3.5 hours.

Administration of Compounds of the Invention

Compounds of Formula I, Formula II, Formula III, Formula IV, and FormulaV can act as prodrugs and thereby exhibit one or more advantages overthe parent opioid drug. For example, compounds of Formula I. Formula II,Formula III, Formula IV, and Formula V can be used to prevent accidentaloverdose by exhibiting a delayed onset of pharmacological activity wheninadvertently orally administered at higher than the prescribed dose. Insome embodiments, compounds of Formula I, Formula II, Formula III,Formula IV, and Formula V can hinder abuse by substantially maintainingtheir chemical form as prodrugs when administered by non-oral routes(e.g., parenteral) likely to be employed by abusers. Thus, compounds ofFormula I, Formula II, Formula III, Formula IV, and Formula V can hinderabuse by reducing availability of the active opioid molecule whenadministered via parenteral routes, particularly the intravenous,intranasal, and/or inhalation routes that are often employed in illicituse.

In some embodiments, compounds of Formula I, Formula II, Formula III,Formula IV, and Formula V have no affinity, or have reduced affinity,for the p opioid receptor as compared to that of the parent opioid.Compounds of Formula I, Formula II, Formula III, Formula IV, and FormulaV can be converted from the prodrug form to the parent opioid under theacid conditions of the stomach. Gradual conversion of a compound ofFormula I, Formula II, Formula III, Formula IV, or Formula V to theparent opioid when administered orally to a mammal should result ingradual but delayed systemic exposure to the parent opioid, as comparedto direct oral administration of the parent opioid.

An opioid prodrug that provides a gradual conversion to the parentopioid can be less attractive to substance abusers or non-medicalrecreational users of opioids who seek drugs to provide rapid euphoria.As conversion from a compound of Formula I, Formula II, Formula III,Formula IV, or Formula V to the parent opioid will be slower, the onsetof euphoria will likewise be slower, thereby resulting in compounds ofthe invention appearing less attractive to those who would attempt suchnon-medical usage of the drug.

In many cases, opioid abuse by the oral route involves immediate releasedrugs, or drugs in which controlled release materials used to delay theliberation and absorption of the opioid from the dosage form have beentampered with. Immediate release opioids generally providepharmacologically relevant plasma concentrations, onset of therapeuticeffects and, in the case of recreational drug users, onset of euphoria,within about 15 to 180 minutes, 15 to 120 minutes, or 15 to 90 minutesafter oral administration.

The gradual conversion of compounds of the invention to the parentopioid in the GI tract may serve to delay, and therefore reduce, anyeuphoric effects otherwise produced by opioids by delaying the time toreach pharmacologically relevant plasma concentrations of oxycodone,e.g., by providing a lower C_(max) and/or a later T_(max) than oral,immediate release forms of opioids. Consequently, in some embodiments,dosage forms of the present invention will have a lower potential forabuse and misuse.

Compounds of Formula I, Formula II, Formula III, Formula IV, and FormulaV can exhibit extended release characteristics. For example, a compoundof the invention can provide a slow conversion to the parent opioid whenadministered orally. FIG. 1 presents the release profile of oxycodonefrom a mixture of isomers of oxycodone 2,4 pentanediol ketals byhydrolysis with 0.1 N HCl at 37° C., which simulates the acidicconditions in the human stomach. FIG. 1 also presents the releaseprofile of oxycodone from a mixture of isomers of oxycodone 2,4pentanediol ketals by hydrolysis in Simulated Gastric Fluid (SGF) (0.2%NaCl and 0.32% pepsin in 0.084 N HCl) at 37° C. As shown, two of theketal isomers, Ketal C and Ketal D, undergo nearly complete hydrolysisin four hours in both 0.1 N HCl and SGF. FIG. 1 shows that differentisomers exhibit different hydrolysis rates, enabling specific controlledrelease profiles of the parent oxycodone to be created by specificallyadjusting the isomer ratios.

FIG. 2 shows the hydrolysis of isomers of hydrocodone 2,4-pentanediolketals in 0.1 N HCl at 37° C. or SGF, respectively. As shown, differentisomers exhibit different hydrolysis rates, enabling specific controlledrelease profiles of the parent hydrocodone to be created by specificallyadjusting isomer ratios.

FIG. 3 presents the release profile of hydromorphone from a mixture offour isomers of hydromorphone 2,4 pentanediol ketals by hydrolysis with0.1 N HCl at 37° C. As shown, one of the ketal isomers, Ketal D,undergoes nearly complete hydrolysis in four hours in 0.1 N HCl. Thus,FIG. 3 shows that different isomers exhibit different hydrolysis rates,enabling specific controlled release profiles of hydromorphone to becreated by specifically adjusting isomer ratios.

FIG. 4 presents the release profile of oxycodone from a mixture ofisomers of oxycodone cis 1,2-cyclohexanedimethanol ketals in 0.1 N HClat 37° C. As shown, the proportion of oxycodone in the mixture increasedfrom about 30% to about 55% within five hours.

FIG. 5 and FIG. 6 present the release profile of hydrocodone fromhydrocodone 1,3-propanediol ketal and hydrocodone 2,5-hexanediol ketal,respectively. In both cases, the ketal compound undergoes nearlycomplete hydrolysis to hydrocodone in about 4 hours, permittingcontrolled release of hydrocodone in a subject by adjusting isomerratios.

FIG. 9 presents the release profile of oxycodone from a mixture ofisomers of Formula IV (isomers IVA-IVD) by hydrolysis with 0.1 N HCl at37° C. As shown, about 50% of the oxycodone is released in about 2.9hours, with almost 90% oxycodone release occurring no later than about25 hours. FIG. 10 shows the hydrolysis of isomers IVC and IVD using 0.1NHCl at 37° C. Isomer IVC appears to be almost completely hydrolyzedwithin 8 hours. Isomer IVD appears to be almost completely hydrolyzedwithin 2 hours.

FIG. 11 presents the release profile of oxycodone from a mixture of fourisomers of Formula V by hydrolysis with 0.1 N HCl at 37° C. As shown,about 50% of the oxycodone is released at about 5 hours, with about 90%release occurring no later than about 25 hours.

An extended release formulation prevents rapid onset of pharmacologicaleffects, and is formulated in such a manner as to make the containedmedication available over an extended period of time. In someembodiments, a compound of Formula I, Formula II, Formula III, FormulaIV, or Formula V can achieve an extended release profile simply based onthe fact that it requires conversion to the parent opioid. Thus, in oneembodiment, compounds of the invention can be formulated without use ofcontrolled release excipients, yet still result in an extended releaseof opioid upon oral administration.

Compounds of the invention can be pharmaceutically formulated to furtherenhance an extended release profile, for example, by formulating thecompound(s) in a dosage form comprising a sustained release matrix or asustained release coating, or some variation thereof. Controlled releaseformulation technology is well-known in the art, and can be used inconjunction with the present invention to obtain particularly desirablerelease profiles. In some embodiments, both the parent opioid and thecompound(s) of the invention can be combined into a single oral dosageform, where the opioid provides an immediate release profile and thecompound(s) of the invention effectively provides an extended releaseprofile of oxycodone. Such combination formulations may or may notfurther comprise a sustained release matrix or a sustained releasecoating, or some variation thereof.

In one embodiment, two or more stereoisomers of one or more compounds ofthe invention are mixed in varying proportions to control the in vivoand/or in vitro release profile of the parent opioid. It has been shownthat the different stereoisomers hydrolyze at different rates, therebyreleasing the parent opioid in a controlled manner. Thus, a number ofpossibilities exist for controlling release of the parent opioid byemploying combinations and amounts of two or more stereoisomers, whereineach stereoisomer hydrolyzes at a different rate in vitro and/or invivo. For example, oxycodone 2R,4R-pentanediol ketal, a stereoisomerthat hydrolyzes relatively quickly can be provided in a mixture withoxycodone 2S,4S-pentanediol ketal, a stereoisomer that hydrolyzesrelatively slowly. These two stereoisomers can then be provided indifferent concentrations and in different proportions to one another toachieve a desired release pattern of the parent opioid. In anothernon-limiting example, hydrocodone 2R,5R-hexanediol ketal, a stereoisomerthat hydrolyzes relatively quickly can be provided in a mixture withhydrocodone 2S,4S-hexanediol ketal, a stereoisomer that hydrolyzesrelatively slowly.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of an opioid in a mammal in need of opioid therapy,the method comprising orally administering to the mammal an effectiveamount of a compound of Formula I, Formula II, Formula III, Formula IV,or Formula V, which exhibits a decreased parenteral (i.e., non-oral)bioavailability compared to the parent opioid. In another embodiment,the present invention provides a method of decreasing the abusepotential of an opioid in a mammal in need of opioid therapy, the methodcomprising orally administering to the mammal an effective amount of amixture of two or more stereoisomers of a compound of Formula I or asalt thereof. In some embodiments, the method comprises orallyadministering to the mammal a mixture of two stereoisomers of a compoundof Formula I at a ratio of about 5:95, about 10:90, about 15:85, about20:80, about 25:75, about 30:70, about 35:65, about 40:60, about 45:55,or about 50:50. In another embodiment, the present invention provides amethod of decreasing the abuse potential of an opioid in a mammal inneed of opioid therapy, the method comprising orally administering tothe mammal an effective amount of a compound of Formula II or a saltthereof. In another embodiment, the present invention provides a methodof decreasing the abuse potential of an opioid in a mammal in need ofopioid therapy, the method comprising orally administering to the mammalan effective amount of a mixture of at least two or more stereoisomersof a compound of Formula III or a salt thereof.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of hydrocodone in a mammal in need of hydrocodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising two or more stereoisomers ofhydrocodone 2,4-pentanediol ketal, or pharmaceutically acceptable saltsthereof, wherein in the compound of Formula I, R₁ is CH₃, R₂ is H, n is1, and R₃ and R₄ are each CH₃. In one embodiment, the method comprisesadministering a mixture of stereoisomers of hydrocodone 2,4-pentanediolketal, or pharmaceutically acceptable salts thereof, wherein in somestereoisomers, the carbon atom labeled * and the carbon atom labeled **are in the RR configuration and in other stereoisomers the carbon atomslabeled * and the carbon atom labeled ** are in the SS configuration. Inanother embodiment, the method comprises administering a mixture ofstereoisomers of hydrocodone 2,4-pentanediol ketal, or pharmaceuticallyacceptable salts thereof, wherein the carbon atom labeled * is in the Rconfiguration and the carbon atom labeled ** is in the S configuration.In another embodiment, the method comprises administering a mixture ofstereoisomers of hydrocodone 2,4-pentanediol ketal, or pharmaceuticallyacceptable salts thereof, in which the carbon atom labeled * is in the Sconfiguration and the carbon atom labeled ** is in the R configuration.In some embodiments, the method comprises orally administering to themammal a mixture of two stereoisomers of hydrocodone 2,4-pentanediolketal at a ratio of about 5:95, about 10:90, about 15:85, about 20:80,about 25:75, about 30:70, about 35:65, about 40:60, about 45:55, orabout 50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of oxycodone in a mammal in need of oxycodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising two or more stereoisomers ofoxycodone 2,5-hexanediol ketal, or pharmaceutically acceptable saltsthereof, wherein in the compound of Formula I, R₁ is CH₃, R₂ is OH, n is2, and R₃ and R₄ are each CH₃. In one embodiment, the method comprisesadministering a mixture of stereoisomers of oxycodone 2,5-hexanediolketal, or pharmaceutically acceptable salts thereof, wherein in somestereoisomers the carbon atom labeled * and the carbon atom labeled **are in the RR configuration and in other stereoisomers the carbon atomlabeled * and the carbon atom labeled ** are in the SS configuration. Inanother embodiment, the method comprises administering a mixture ofstereoisomers of oxycodone 2,5-hexanediol ketal, or pharmaceuticallyacceptable salts thereof, wherein the carbon atom labeled * is in the Rconfiguration and the carbon atom labeled ** is in the S configuration.In another embodiment, the method comprises administering a mixture ofstereoisomers of oxycodone 2,5-hexanediol ketal, or pharmaceuticallyacceptable salts thereof, wherein the carbon atom labeled * is in the Sconfiguration and the carbon atom labeled ** is in the R configuration.In some embodiments, the method comprises orally administering to themammal a mixture of two stereoisomers of oxycodone 2,5-hexanediol ketalat a ratio of about 5:95, about 10:90, about 15:85, about 20:80, about25:75, about 30:70, about 35:65, about 40:60, about 45:55, or about50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of hydrocodone in a mammal in need of hydrocodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising two or more stereoisomers ofhydrocodone 2,5-hexanediol ketal, or pharmaceutically acceptable saltsthereof, wherein R₁ is CH₃, R₂ is H, n is 2, and R₃ and R₄ are each CH₃.In one embodiment, the method comprises administering a mixture ofstereoisomers of hydrocodone 2,5-hexanediol ketal, or pharmaceuticallyacceptable salts thereof, wherein in some stereoisomers the carbon atomlabeled * and the carbon atom labeled ** are in the RR configuration andin other stereoisomers the carbon atoms labeled * and the carbon atomlabeled ** are in the SS configuration. In another embodiment, themethod comprises administering a mixture of stereoisomers of hydrocodone2,5-hexanediol ketal, or pharmaceutically acceptable salts thereof,wherein the carbon atom labeled * is in the R configuration and thecarbon atom labeled ** is in the S configuration. In another embodiment,the method comprises administering a mixture of stereoisomers ofhydrocodone 2,5-hexanediol ketal, or pharmaceutically acceptable saltsthereof, wherein the carbon atom labeled * is in the S configuration andthe carbon atom labeled ** is in the R configuration. In someembodiments, the method comprises orally administering to the mammal amixture of two stereoisomers of hydrocodone 2,5-hexanediol ketal at aratio of about 5:95, about 10:90, about 15:85, about 20:80, about 25:75,about 30:70, about 35:65, about 40:60, about 45:55, or about 50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of hydromorphone in a mammal in need ofhydromorphone therapy, the method comprising orally administering to themammal an effective amount of a mixture comprising two or morestereoisomers of hydromorphone 2,4-pentanediol ketal, orpharmaceutically acceptable salts thereof, wherein R₁ is H, R₂ is H, nis 1, and R₃ and R₄ are each CH₃. In one embodiment, the methodcomprises administering a mixture of stereoisomers of hydromorphone2,4-pentanediol ketal, or pharmaceutically acceptable salts thereof,wherein in some stereoisomers the carbon atom labeled * and the carbonatom labeled ** are in the RR configuration and in other stereoisomersthe carbon atoms labeled * and ** are in the SS configuration. Inanother embodiment, the method comprises administering a mixture ofstereoisomers of hydromorphone 2,4-pentanediol ketal, orpharmaceutically acceptable salts thereof, wherein the carbon atomlabeled * is in the R configuration and the carbon atom labeled ** is inthe S configuration. In another embodiment, the method comprisesadministering a mixture of stereoisomers of hydromorphone2,4-pentanediol ketal, or pharmaceutically acceptable salts thereof,wherein the carbon atom labeled * is in the S configuration and thecarbon atom labeled ** is in the R configuration. In some embodiments,the method comprises orally administering to the mammal a mixture of twostereoisomers of hydromorphone 2,4-pentanediol ketal at a ratio of about5:95, about 10:90, about 15:85, about 20:80, about 25:75, about 30:70,about 35:65, about 40:60, about 45:55, or about 50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of oxycodone in a mammal in need of oxycodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising two or more stereoisomers ofoxycodone 1,2-cyclohexanediol ketal, or pharmaceutically acceptablesalts thereof. In one embodiment, the method comprises administering amixture of stereoisomers of oxycodone 1,2-cyclohexanediol ketal, orsalts thereof, wherein the carbon atom labeled * and the carbon atomlabeled ** are in the cis configuration relative to each other. Inanother embodiment, the method comprises administering a mixture ofstereoisomers of oxycodone 1,2-cyclohexanediol ketal, or salts thereof,wherein the carbon atom labeled * and the carbon atom labeled ** are inthe trans configuration relative to each other. In some embodiments, themethod comprises orally administering to the mammal a mixture of twostereoisomers of oxycodone 1,2-cyclohexanediol ketal at a ratio of about5:95, about 10:90, about 15:85, about 20:80, about 25:75, about 30:70,about 35:65, about 40:60, about 45:55, or about 50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of oxycodone in a mammal in need of oxycodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising two or more stereoisomers of acompound Formula III, or pharmaceutically acceptable salts thereof. Inone embodiment, the method comprises administering a mixture ofstereoisomers of a compound of Formula III, or salts thereof, whereinthe carbon atoms labeled * are in the cis configuration to each other.In another embodiment, the method comprises administering a mixture ofstereoisomers of a compound of Formula III, or salts thereof, whereinthe carbon atoms labeled * are in the trans configuration to each other.In some embodiments, the method comprises orally administering to themammal a mixture of two isomers of a compound of Formula III at a ratioof about 5:95, about 10:90, about 15:85, about 20:80, about 25:75, about30:70, about 35:65, about 40:60, about 45:55, or about 50:50.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of hydrocodone in a mammal in need of hydrocodonetherapy, the method comprising orally administering to the mammal aneffective amount of hydrocodone 1,3-propanediol ketal, orpharmaceutically acceptable salts thereof.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of oxycodone in a mammal in need of oxycodonetherapy, the method comprising orally administering to the mammal aneffective amount of a compound of Formula IV or Formula V, whichexhibits a decreased parenteral (i.e., non-oral) bioavailabilitycompared to oxycodone. In another embodiment, the present inventionprovides a method of decreasing the abuse potential of oxycodone in amammal in need of oxycodone therapy, the method comprising orallyadministering to the mammal an effective amount of a mixture of at leasttwo isomers selected from the group consisting of isomers IVA, IVB, IVC,and IVD. In another embodiment, the present invention provides a methodof decreasing the abuse potential of oxycodone in a mammal in need ofoxycodone therapy, the method comprising orally administering to themammal an effective amount of a mixture of at least two isomers selectedfrom the group consisting of isomers VA, VB, VC, and VD.

In one embodiment, the present invention provides a method of decreasingthe abuse potential of oxycodone in a mammal in need of oxycodonetherapy, the method comprising orally administering to the mammal aneffective amount of a mixture comprising isomers IVC and IVD. In anotherembodiment, the method of decreasing the abuse potential of oxycodonecomprises orally administering to the mammal an effective amount of amixture comprising isomers IVC and IVD, wherein the isomer IVC ispresent in a molar amount greater than isomer IVD. In yet anotherembodiment, the method of decreasing the abuse potential of oxycodonecomprises administering a mixture comprising isomers IVC and IVD,wherein the isomer IVD is present in a molar amount greater than isomerIVC.

In one embodiment, the method of decreasing the abuse potential ofoxycodone comprises orally administering to the mammal an effectiveamount of a mixture comprising isomers IVA, IVB, IVC, and IVD. Incertain embodiments, the isomers IVC and IVD together are present in anaggregate molar amount greater than isomers IVA and IVB together.

In one embodiment, the method of decreasing the abuse potential of anopioid comprises orally administering to the mammal an effective amountof a mixture, comprising at least two compounds selected from the groupconsisting of stereoisomers of Formula I, Formula II, Formula III, andsalts thereof, wherein at least about 10%, at least about 20%, at leastabout 30%, at least about 40%, or at least about 50% of the aggregatemolar amount of isomers is hydrolyzed to the parent opioid at 37° C. in0.1 N HCl within about 2 hours. In a particular embodiment, the methodcomprises administering at least two stereoisomers of: hydrocodone2,4-pentanediol ketal; oxycodone 2,5-hexanediol ketal; hydrocodone2,5-hexanediol ketal; hydromorphone 2,4-pentanediol ketal; oxycodone1,2-cyclohexanediol ketal; a compound of Formula III, or salts thereof.

In one embodiment, the invention is a method of decreasing the abusepotential of an opioid comprising orally administering to the mammal aneffective amount of a compound of Formula I or a pharmaceuticallyacceptable salt thereof, with the proviso that the compound is nothydrocodone ethyleneglycol ketal, hydromorphone ethyleneglycol ketal,oxycodone ethyleneglycol ketal, hydrocodone 1,3-propanediol ketal,oxycodone 1,3-propanediol ketal, hydromorphone 1,3-propanediol ketal, ora pharmaceutically acceptable salt thereof. In one embodiment, themethod of decreasing the abuse potential of an opioid comprises orallyadministering to the mammal an effective amount of a mixture comprisingat least two compounds selected from the group consisting ofstereoisomers of Formula I and the pharmaceutically acceptable saltsthereof, with the proviso that the mixture is not a mixture ofstereoisomers of hydrocodone 2,3-butanediol ketal, oxycodone2,3-butanediol ketal, hydrocodone 2,3-butanediol ketal, or anypharmaceutically acceptable salts thereof.

In one embodiment, the invention is a method of decreasing the abusepotential of oxycodone comprising orally administering to the mammal aneffective amount of a mixture comprising at least two compounds selectedfrom the group consisting of isomers IVA, IVB, IVC, IVD, VA, VB, VC, andVD and the pharmaceutically acceptable salts thereof, wherein at leastabout 10%, at least about 20%, at least about 30%, at least about 40%,or at least about 50% of the aggregate molar amount of the isomers arehydrolyzed to oxycodone at 37° C. in 0.1 N HCl within about 2 hours.

In one embodiment, the invention is a method of achieving opioid therapyin a mammal, comprising orally administering to the mammal atherapeutically effective amount of a compound of Formula I, Formula II,or Formula III, or a pharmaceutically acceptable salt thereof, whereinat least about 10%, at least about 20%, at least about 30%, at leastabout 40%, or at least about 50% of the aggregate molar amount of thecompound of Formula I, Formula II, or Formula III, or salt thereof, ishydrolyzed to the parent opioid within about 2 hours at 37° C. in 0.1 NHCl. In a particular embodiment, the method comprises orallyadministering to the mammal a therapeutically effective amount of acompound of Formula I, Formula II, or Formula III, or pharmaceuticallyacceptable salt thereof, wherein at least about 10%, at least about 20%,at least about 30%, at least about 40%, at least about 50%, at leastabout 60%, at least about 70/a, at least about 80%, at least about 90%,or about 100% of the compound of Formula I, Formula II, or Formula III,or pharmaceutically acceptable salt thereof, is hydrolyzed to the parentopioid within about 4 hours at 37° C. in 0.1 N HCl.

In one embodiment, the invention is a method of achieving opioid therapyin a mammal, comprising orally administering an excess of a stereoisomerof hydrocodone 2,4-pentanediol ketal, oxycodone 2,5-hexanediol ketal,hydrocodone 2,5-hexanediol ketal, hydromorphone 2,4-pentanediol ketal,oxycodone 1,2-cyclohexanediol ketal, compound of Formula III, orpharmaceutically acceptable salt thereof, wherein about 80%, about 90%,about 95%, or about 100% of the stereoisomer is hydrolyzed to the parentopioid within about 8 hours at 37° C. in 0.1 N HCl. In particularembodiments, the method comprises orally administering the RR or SSisomer of hydrocodone 2,4-pentanediol ketal; the RR or SS isomer ofhydromorphone 2,4-pentanediol ketal; the RR or SS isomer of oxycodone2,5-hexanediol ketal; the RR or SS isomer of hydrocodone 2,5-hexanediolketal; hydrocodone 1,3-propanediol ketal; or a pharmaceuticallyacceptable salt thereof. In each case, the carbon atom labeled * and thecarbon atom labeled ** in the compound of Formula I are both in the Rconfigurations or both in the S configurations.

In one embodiment, the invention is a method of achieving opioid therapyin a mammal in need of said therapy, comprising orally administering tothe mammal a therapeutically effective amount of a compound of FormulaI, or pharmaceutically acceptable salt thereof, with the proviso thatthe compound is not hydrocodone ethyleneglycol ketal; hydromorphoneethyleneglycol ketal; oxycodone ethyleneglycol ketal; hydrocodone1,3-propanediol ketal; oxycodone 1,3-propanediol ketal; hydromorphone1,3-propanediol ketal; or a salt thereof. In one embodiment, theinvention is a method of achieving opioid therapy in a mammal in need ofsaid therapy, comprising orally administering to the mammal atherapeutically effective amount of a mixture of stereoisomers of acompound of Formula I, or pharmaceutically acceptable salts thereof,with the proviso that the mixture is not a mixture of stereoisomers ofhydrocodone 2,3-butanediol ketal; oxycodone 2,3-butanediol ketal;hydrocodone 2,3-butanediol ketal; or salts thereof.

In another embodiment, the invention is a method of achieving opioidtherapy in a mammal in need of said therapy, comprising orallyadministering to the mammal a therapeutically effective amount of amixture of isomers of Formula I, Formula II, and Formula III, orpharmaceutically acceptable salts thereof, wherein at least about 10%,at least about 20%, at least about 30%, at least about 40%, or at leastabout 50% of the mixture is hydrolyzed to the parent opioids withinabout 2 hours at 37° C. in 0.1 N HCl. In a particular embodiment, themethod comprises orally administering to the mammal a therapeuticallyeffective amount of a mixture of isomers of Formula I, Formula II, andFormula III, or pharmaceutically acceptable salts thereof, wherein atleast about 10%, at least about 20%, at least about 30%, at least about40%, at least about 50%, at least about 60%, at least about 70%, atleast about 90%, or about 100% of a molar equivalent of the mixture ofisomers of the compound of Formula I, Formula II, or Formula III ishydrolyzed to the parent opioid within about 4 hours at 37° C. in 0.1 NHCl.

In one embodiment, the invention is a method of achieving oxycodonetherapy in a mammal in need of said therapy, comprising orallyadministering to the mammal a therapeutically effective amount of acompound of Formula IV or Formula V, or pharmaceutically acceptable saltthereof, wherein at least about 10%, at least about 20%, at least about30%, at least about 40%, or at least about 50% of the compound ofFormula IV or Formula V or salt is hydrolyzed to oxycodone within about2 hours at 37° C. in 0.1 N HCl. In a particular embodiment, the methodcomprises orally administering to the mammal a therapeutically effectiveamount of a compound of Formula IV or Formula V, or pharmaceuticallyacceptable salt thereof, wherein at least about 10%, at least about 20%,at least about 30%, at least about 40%, at least about 50%, at leastabout 60%, at least about 70%, at least about 90° %, or about 100% ofthe compound of Formula IV or Formula V or salt is hydrolyzed tooxycodone within about 4 hours at 37° C. in 0.1 N HCl. In oneembodiment, the method comprises orally administering isomer IVC, orpharmaceutically acceptable salt thereof, wherein about 80%, about 90%,about 95%, or about 100% of isomer IVC or salt is hydrolyzed tooxycodone within about 8 hours at 37° C. in 0.1 N HCl. In anotherembodiment, the method comprises orally administering isomer IVD, orpharmaceutically acceptable salt thereof, wherein about 80%, about 90%,about 95%, or about 100% of the compound of Formula IVD or salt ishydrolyzed to oxycodone within about 2 hours at 37° C. in 0.1 N HCl.

In another embodiment, the invention is a method of achieving oxycodonetherapy in a mammal in need of said therapy, comprising orallyadministering to the mammal a therapeutically effective amount of amixture of isomers of Formula IV and Formula V, or pharmaceuticallyacceptable salts thereof, wherein at least about 10%, at least about20%, at least about 30%, at least about 40%, or at least about 50% ofthe mixture is hydrolyzed to oxycodone within about 2 hours at 37° C. in0.1 N HCl. In a particular embodiment, the method comprises orallyadministering to the mammal a therapeutically effective amount of amixture of isomers of Formula IV and Formula V, or pharmaceuticallyacceptable salts thereof, wherein at least about 10%, at least about20%, at least about 30%, at least about 40%, at least about 50%, atleast about 60%, at least about 70%, at least about 90%, or about 100%of the compound of Formula IV or Formula V or salt is hydrolyzed tooxycodone within about 4 hours at 37° C. in 0.1 N HCl.

In some embodiments, the compound of Formula I, Formula II, Formula III,Formula IV, or Formula V provides bioavailability of the parent opioidby any parenteral route (for example, intravenous, intranasal, orinhalation) of less than about 70%, less than about 50%, less than about30%, less than about 20%, less than about 15%, less than about 10%, lessthan about 5%, less than about 4%, less than about 3%, less than about2%, or less than about 1% of the bioavailability of the parent opioidadministered by the same route.

Compounds of the present invention exhibit a relatively high degree ofstability, that is, resistance to hydrolysis, when subject to “kitchenchemistry” which might be used by a potential abuser. FIG. 12 presentsthe degree of hydrolysis of a mixture of the isomers of Formula IV(IVA-IVD) in the presence of 5% acetic acid at 100° C., which simulatesboiling vinegar. As shown, a mixture of the isomers of Formula IV(IVA-IVD) requires about 2 hours in 5% acetic acid at 100° C. to exhibitabout 80% hydrolysis to oxycodone and about 10 hours to almostcompletely hydrolyze to oxycodone. As shown in FIG. 13 , a mixture ofthe isomers of Formula V requires about 1 hour to undergo about 60%hydrolysis and at least about 4 hours to almost completely hydrolyze tooxycodone when subjected to the same conditions.

Pharmaceutical Compositions

The present invention is further directed to pharmaceutical compositionscomprising a therapeutically effective amount of at least one compoundof Formula I, Formula II, Formula III, Formula IV, or Formula V, or apharmaceutically acceptable salt thereof, and a pharmaceuticallyacceptable carrier. Pharmaceutical compositions of the present inventioncan, if desired, also contain one or more other compatiblepharmaceutically active agents.

Pharmaceutical compositions within the scope of this invention includeall compositions wherein a compound of Formula I, Formula II, FormulaIII, Formula IV, or Formula V, or a pharmaceutically acceptable saltthereof, is present in an amount that is effective (via conversion tothe parent opioid) to achieve its intended purpose. While individualneeds will vary, determination of optimal ranges of effective amounts ofeach component is within the skill in the art in view of the presentdisclosure. In some embodiments, a compound of Formula I, Formula II,Formula III, Formula IV, or Formula V, or a pharmaceutically acceptablesalt thereof, or a mixture thereof, can be administered to a mammal. Insome embodiments, the mammal is a human, and preferably a patient beingtreated for a condition that can be treated with an opioid, such aspain. As will be evident from this disclosure, compounds of Formula I,Formula II, Formula III, Formula IV, Formula V, pharmaceuticallyacceptable salts thereof, and mixtures thereof, are preferablyadministered orally. In some embodiments, a compound of Formula I,Formula II, Formula III, Formula IV, or Formula V is administered at adose of from 0.1 to 5 mg/kg, or a molar equivalent amount of thepharmaceutically acceptable salt thereof, of the body weight of themammal being treated.

In some embodiments, the unit oral dosage comprises between 5 mg and 640mg, between 5 mg and 320 mg, between 5 mg and 200 mg, between 5 mg and160 mg, between 5 mg and 100 mg, between 5 mg and 50 mg, between 5 mgand 25 mg, between 5 mg and 20 mg, and between 5 mg and 10 mg of acompound of Formula I, Formula II, Formula III, Formula IV, or FormulaV, or a pharmaceutically acceptable salt thereof, or mixtures thereof.In some embodiments, the unit oral dose is 5 mg, 10 mg, 20 mg, 25 mg, 50mg, 60 mg, 80 mg, 100 mg, 120 mg, 160 mg, 320 mg, or 640 mg of acompound of Formula I, Formula II, Formula III, Formula IV, or FormulaV, or a molar equivalent of a pharmaceutically acceptable salt thereof.

In some embodiments, the oral dosage form is a unit oral dosage formthat is administered every 4 hours, every 6 hours, every 8 hours, every12 hours, or every 24 hours.

In some embodiments, a compound of Formula I, Formula II, Formula III,Formula IV, Formula V, or a pharmaceutically acceptable salt thereof, ora mixture thereof, can be administered as part of a pharmaceuticalcomposition. In some embodiments, the pharmaceutical compositions of theinvention contain one or more suitable pharmaceutically acceptablecarriers selected from known excipients and auxiliaries to facilitateprocessing of the compounds into pharmaceutical dosage forms and/or tofacilitate or otherwise control dissolution of the dosage form. In aparticular embodiment, pharmaceutical compositions of the invention arein dosage forms that can be administered orally. In some embodiments,the pharmaceutical compositions are in the form of solid oral dosageforms, such as powders, granules, tablets, pellets, multiparticulates,dragees, or capsules. In other embodiments, the pharmaceuticalcompositions are in the form of liquid oral dosage forms, such as oralsolutions, oral suspensions, or oral emulsions.

In some embodiments, the oral dosage form contains from 0.01 to 99weight percent, 0.01 to 90 weight percent, 0.01 to 85 weight percent,0.01 to 80 weight percent, or 0.01 to 75 weight percent of a compound ofFormula I, Formula II, Formula III, Formula IV, Formula V, or apharmaceutically acceptable salt thereof, or a mixture thereof, togetherwith one or more excipients.

Orally administered pharmaceutical compositions of the invention cancontain one or more excipients. Suitable excipients include fillers suchas saccharides, for example lactose or sucrose, mannitol, sodiumsaccharin or sorbitol, magnesium carbonate, cellulose preparationsand/or calcium phosphates, for example tricalcium phosphate or calciumhydrogen phosphate, as well as binders such as starch paste, using, forexample, maize starch, wheat starch, rice starch, potato starch,gelatin, tragacanth, methyl cellulose, hydroxypropylmethylcellulose,sodium carboxymethylcellulose, and/or polyvinyl pyrrolidone. If desired,disintegrating agents can be added such as the above-mentioned starchesand also carboxymethyl-starch, cross-linked polyvinyl pyrrolidone, agar,or alginic acid or a salt thereof, such as sodium alginate. Auxiliariesare, above all, flow-regulating agents and lubricants, for example,silica, talc, stearic acid or salts thereof, such as magnesium stearateor calcium stearate, and/or polyethylene glycol; sweetening agents suchas fructose, aspartame or saccharin; flavoring agents such aspeppermint, oil of wintergreen, or cherry; coloring agents; andpreserving agents, to provide a pharmaceutically palatable preparation.In addition, dye stuffs or pigments can be added to the tablets ordragee coatings, for example, for identification or in order tocharacterize combinations of active compound doses. Other examples ofsuitable pharmaceutical excipients are described in Remington'sPharmaceutical Sciences pp. 1447-1676 (Alfonso R. Gennaro ed., 19th ed.1995), incorporated herein by reference. In one embodiment, theexcipients are of pharmaceutical grade.

In some embodiments, pharmaceutical compositions of the presentinvention are manufactured in a manner which will be known in view ofthe present disclosure, such as, for example, by means of conventionalmixing, granulating, dragee-making, dissolving, or lyophilizingprocesses.

Pharmaceutical compositions of the invention can be administered by anymeans to achieve their intended purpose. Preferably, administration isby the oral route. The dose administered and the frequency of dosingwill be dependent upon the age, health, gender, medical condition andweight of the recipient, any concurrent treatment if any, frequency oftreatment, and the nature of the effect desired, among other factors.

A compound of Formula I, Formula II, Formula III, Formula IV, Formula V,or a pharmaceutically acceptable salt thereof, or a mixture thereof, canbe delivered in an immediate release system, a controlled-release systemor a sustained-release system. For a more detailed description of thecontrolled- or sustained-release systems, see e.g. U.S. Pat. Nos.5,672,360, 5,968,551, 6,294,195, 7,270,831, and 7,514,100. Thecontrolled- or sustained-release systems can also be prepared by methodsknown in the art (see, e.g., Goodson, in Medical Applications ofControlled Release, vol. 2, pp. 115-138 (1984)). Other controlled- orsustained-release systems discussed in the review by Langer, Science249:1527-1533 (1990) can be used as well.

A compound of Formula I, Formula II, Formula III, Formula IV, Formula V,or a pharmaceutically acceptable salt thereof, or a mixture thereof, canbe prepared as a gastric-retentive drug delivery system, which isretained in the stomach or upper part of the gastrointestinal tract forcontrolled delivery. For a more detailed description ofgastric-retentive drug delivery systems, see e.g. U.S. Pat. Nos.5,232,704; 7,157,100; 7,838,028: and U.S. Patent Appl. Publication No.2006/0013876. Gastric-retentive drug delivery systems can also beprepared by methods known in the art (see, e.g., Sharma, N., et al.,International Journal of Research in Pharmaceutical and BiomedicalSciences 2:428-441 (2011)).

The production of tablets and granules as disclosed in U.S. Pat. Nos.4,167,558 and 6,090,411 can also be used. The preparation of bilayeredtablets as disclosed in U.S. Pat. No. 4,140,755 can also be used.

Powders comprising the active agent, a hydrocolloid, a pH dependentpolymer, and a binder, with all of these being placed in a capsule, aredisclosed in U.S. Pat. No. 5,169,638. The forms disclosed in saiddocument are suitable for delivering compounds of the present invention.

U.S. Pat. No. 6,635,279 discloses a mixture of polyvinyl acetate andpolyvinylpyrrolidone, as well as excipients. These forms can be preparedby simple processes and show exceptional mechanical strengths. The formsdisclosed in said document are suitable for delivering a compound orcompounds of the present invention.

In some embodiments, a compound or compounds of the present inventionare co-administered with one or more other therapeutic agents.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more non-opioid analgesics. Suitablenon-opioid analgesics include, but are not limited to a non-steroidalanti-inflammatory agent selected from aspirin, ibuprofen, diclofenac,naproxen, benoxaprofen, flurbiprofen, fenoprofen, flubufen, ketoprofen,indoprofen, piroprofen, carprofen, oxaprozin, pramoprofen, muroprofen,trioxaprofen, suprofen, aminoprofen, tiaprofenic acid, fluprofen,bucloxic acid, indomethacin, sulindac, tolmetin, zomepirac, tiopinac,zidometacin, acemetacin, fentiazac, clidanac, oxpinac, mefenamic acid,meclofenamic acid, flufenamic acid, niflumic acid tolfenamic acid,diflurisal, flufenisal, piroxicam, sudoxicam, isoxicam, pharmaceuticallyacceptable salts thereof, and mixtures thereof. Other suitablenon-opioid analgesics include, but are not limited to, salicylic acidderivatives, including without limitation, sodium salicylate, cholinemagnesium trisalicylate, salsalate, diflunisal, salicylsalicylic acid,sulfasalazine, and olsalazin; para-aminophennol derivatives includingwithout limitation, acetaminophen; indole and indene acetic acids,including without limitation, indomethacin, sulindac, and etodolac;heteroaryl acetic acids, including without limitation, tolmetin,diclofenac, and ketorolac; anthranilic acids (fenamates), includingmefenamic acid and meclofenamic acid; enolic acids, including withoutlimitation, oxicams (piroxicam and tenoxicam), and pyraznlidinediones(phenylbutazone and oxyphenthartazone); and alkanones, including withoutlimitation, nabumetone. For a more detailed description of thenon-opioid analgesics that can be co-administered with a compound ofFormula I, Formula II, or Formula III, or a salt thereof, according tothe present invention, see Paul A. Insel, Analgesic-Antipyretic andAntiinflammatory Agents and Drugs Employed in The Treatment of Gout inGoodman & Gilman's The Pharmacological Basis of Therapeutics, 617-657(Perry B. Molinhoff and Raymond W. Ruddon, eds., 9th ed. 1996), and GlenR. Hanson, Analgesic, Antipyrctic and Anti-Inflammatory Drugs inRemington: The Science and Practice of Pharmacy, vol. II, 1196-1221 (A.R. Gennaro, ed. 19th ed. 1995).

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more opioid agonists. Suitable opioidagonists include, but are not limited to, alfentanil, allylprodine,alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine,butorphanol, clonitazene, codeine, desomorphine, dextromoramide,dezocine, diampromide, diamorphone, dihydrocodeine, dihydromorphine,dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate,dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene,ethylmorphine, etonitazene, fentanyl, heroin, hydrocodone,hydromorphone, hydroxypethidine, isomethadone, ketobemidone,levorphanol, levophenacylmorphan, lofentanil, meperidine, meptazinol,metazocine, methadone, metopon, morphine, myrophine, nalbuphine,narceine, nicomorphine, norlevorphanol, normethadone, nalorphine,normorphine, norpipanone, opium, oxycodone, oxymorphone, papaveretum,pentazocine, phenadoxone, phenomorphan, phenazocine, phenoperidine,piminodine, piritramide, proheptazine, promedol, properidine, propiram,propoxyphene, sufentanil, tilidine, tramadol, pharmaceuticallyacceptable salts thereof, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more antimigraine agents. Suitableantimigraine agents include, but are not limited to, alpiropride,dihydroergotamine, dolasetron, ergocornine, ergocorninine, ergocryptine,ergot, ergotamine, flumedroxone acetate, fonazine, lisuride, lomerizine,methysergide oxetorone, pizotyline, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more antiemetic agents. Suitableantiemetic agents include, but are not limited to, metoclopromide,domperidone, prochlorperazine, promethazine, chlorpromazine,trimethobenzamide, ondansetron, granisetron, hydroxyzine acethylleucinemonoethanolamine, alizapride, azasetron, benzquinamide, bietanautine,bromopride, buclizine, clebopride, cyclizine, dimenhydrinate,diphenidol, dolasetron, meclizine, methallatal, metopimazine, nabilone,oxyperndyl, pipamazine, scopolamine, sulpiride, tetrahydrocannabinols,thiethylperazine, thioproperazine, tropisetron, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more p-adrenergic blockers. Suitablep-adrenergic blockers include, but are not limited to, acebutolol,alprenolol, amosulabol, arotinolol, atenolol, befunolol, betaxolol,bevantolol, bisoprolol, bopindolol, bucumolol, bufetolol, bufuralol,bunitrolol, bupranolol, butidrine hydrochloride, butofilolol, carazolol,carteolol, carvedilol, celiprolol, cetamolol, cloranolol, dilcvalol,epanolol, esmolol, indenolol, labetalol, levobunolol, mepindolol,metipranolol, metoprolol, moprolol, nadolol, nadoxolol, nebivalol,nifenalol, nipradilol, oxprenolol, penbutolol, pindolol, practolol,pronethalol, propranolol, sotalol, sulfinalol, talinolol, tertatolol,tilisolol, timolol, toliprolol, xibenolol, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more anticonvulsants. Suitableanticonvulsants include, but are not limited to, acetylpheneturide,albutoin, aloxidone, aminoglutethimide, 4-amino-3-hydroxybutyric acid,atrolactamide, beclamide, buramate, calcium bromide, carbamazepine,cinromide, clomethiazole, clonazepam, decimemide, diethadione,dimethadione, doxenitroin, eterobarb, ethadione, ethosuximide, ethotoin,felbamate, fluoresone, gabapentin, 5-hydroxytryptophan, lamotrigine,magnesium bromide, magnesium sulfate, mephenytoin, mephobarbital,metharbital, methetoin, methsuximide,5-methyl-5-(3-phenanthryl)-hydantoin, 3-methyl-5-phenylhydantoin,narcobarbital, nimetazepam, nitrazepam, oxcarbazepine, paramethadione,phenacemide, phenetharbital, pheneturide, phenobarbital, phensuximide,phenylmethylbarbituric acid, phenytoin, phethenylate sodium, potassiumbromide, pregabaline, primidone, progabide, sodium bromide, solanum,strontium bromide, suclofenide, sulthiame, tetrantoin, tiagabine,topiramate, trimethadione, valproic acid, valpromide, vigabatrin,zonisamide, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more antidepressants. Suitableantidepressants include, but are not limited to, binedaline, caroxazone,citalopram, dimethazan, fencamine, indalpine, indeloxazinehydrocholoride, nefopam, nomifensine, oxitriptan, oxypertine,paroxetine, sertraline, thiazesim, trazodone, benmoxine, iproclozide,iproniazid, isocarboxazid, nialamide, octamoxin, phenelzine, cotinine,rolicyprine, rolipram, maprotiline, metralindole, mianserin,mirtazepine, adinazolam, amitriptyline, amitriptylinoxide, amoxapine,butriptyline, clomipramine, demexiptiline, desipramine, dibenzepin,dimetacrine, dothiepin, doxepin, fluacizine, imipramine, imipramineN-oxide, iprindole, lofepramine, melitracen, metapramine, nortriptyline,noxiptilin, opipramol, pizotyline, propizepine, protriptyline,quinupramine, tianeptine, trimipramine, adrafinil, benactyzine,bupropion, butacetin, dioxadrol, duloxetine, etoperidone, febarbamate,femoxetine, fenpentadiol, fluoxetine, fluvoxamine, hematoporphyrin,hypericin, levophacetoperane, medifoxamine, milnacipran, minaprine,moclobemide, nefazodone, oxaflozane, piberaline, prolintane,pyrisuccideanol, ritanserin, roxindole, rubidium chloride, sulpiride,tandospirone, thozalinone, tofenacin, toloxatone, tranylcypromine,L-tryptophan, venlafaxine, viloxazine, zimeldine, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventioncan be co-administered with one or more Ca²⁺-channel blockers. SuitableCa²⁺-channel blockers include, but are not limited to, bepridil,clentiazem, diltiazem, fendiline, gallopamil, mibefradil, prenylamine,semotiadil, terodiline, verapamil, amlodipine, aranidipine, barnidipine,benidipine, cilnidipine, efonidipine, elgodipine, felodipine,isradipine, lacidipine, lercanidipine, manidipine, nicardipine,nifedipine, nilvadipine, nimodipine, nisoldipine, nitrendipine,cinnarizine, flunarizine, lidoflazine, lormerizine, bencyclane,etafenone, fantofarone, perhexiline, and mixtures thereof.

In some embodiments, a compound or compounds of the present inventionare co-formulated or co-administered with an opioid antagonist, such asnaltrexone, naloxone, nalmefene, nalorphine, nalbuphine, naloxoneazinen,methylnaltrexone, ketylcyclazocine, norbinaltorphimine, naltrindole,6-β-naloxol, 6-β-naltrexol, alvimopan, cyprodime, diprenorphine,gemazocine, 5′-guanidinonaltrindole, JDTic((3R)-7-Hydroxy-N-[(2S)-1-[(3R,4R)-4-(3-hydroxyphenyl)-3,4-dimethylpiperidin-1-yl]-3-methylbutan-2-yl]-1,2,3,4-tetrahydroisoquinoline-3-carboxamide),levallorphan, naldemedine, nalmexone, nalorphine dinicotinate,naloxazone, naloxegol, naloxol, naoloxonazine, naltiben, oxilorphan,quadazocine, samidorphan, and mixtures thereof according toInternational Patent Appl. Publication No. WO 03/084520.

Since compounds of of the present invention can act as opioid prodrugs,they can be used for the same purpose as their parent opioids. In someembodiments, the compounds of the invention are useful for treating,ameliorating or preventing pain including acute pain, chronic pain,neuropathic pain, inflammatory pain, and surgical pain. Acute painincludes, but is not limited to, peri-operative pain, post-operativepain, post-traumatic pain, acute disease-related pain, and pain relatedto diagnostic procedures, orthopedic manipulations, and myocardialinfarction. Acute pain in the peri-operative setting includes painresulting from a pre-existing disease, a surgical procedure, e.g.,associated drains, chest or nasogastric tubes, or complications, or acombination of disease-related and procedure-related sources. Chronicpain includes, but is not limited to, inflammatory pain, post-operativepain, cancer pain, osteoarthritis pain associated with metastaticcancer, trigeminal neuralgia, acute herpetic and post-herpeticneuralgia, diabetic neuropathy, causalgia, brachial plexus avulsion,occipital neuralgia, reflex sympathetic dystrophy, fibromyalgia, gout,phantom limb pain, burn pain, and other forms of neuralgia, neuropathic,and idiopathic pain syndromes.

Chronic pain or neuropathic pain is a heterogencous disease state withan unclear etiology. In chronic pain, the pain can be mediated bymultiple mechanisms. This type of pain generally arises from injury tothe peripheral or central nervous tissue. In some embodiments, pain isassociated with spinal cord injury, multiple sclerosis, post-herpeticneuralgia, trigeminal neuralgia, phantom pain, causalgia, reflexsympathetic dystrophy, and lower back pain. Chronic pain is differentfrom acute pain in that patients suffer the abnormal pain sensationsthat can be described as spontaneous pain, continuous superficialburning, and/or deep aching pain. The pain can be evoked by heat-,cold-, and mechano-hyperalgesia or by heat-, cold-, ormechano-allodynia.

Neuropathic pain can be caused by injury or infection of peripheralsensory nerves. It includes, but is not limited to, pain from peripheralnerve trauma, herpes virus infection, diabetes mellitus, causalgia,plexus avulsion, neuroma, limb amputation, and vasculitis. Neuropathicpain is also caused by nerve damage from chronic alcoholism, humanimmunodeficiency virus infection, hypothyroidism, uremia, or vitamindeficiencies. Neuropathic pain includes but is not limited to paincaused by nerve injury such as, for example, the pain from whichdiabetics suffer.

In some embodiments, compounds of the invention are useful as coughsuppressants, and in treating or ameliorating dyspnea, diarrhea, anddysentery.

In each of the aforementioned instances, the methods of the presentinvention require administering to a mammal in need of such treatment aneffective amount of a compound of Formula I, Formula II, Formula III,Formula IV, Formula V, or a pharmaceutically acceptable salt thereof, ora mixture thereof.

In some embodiments, compounds of the invention are tested for their popioid receptor binding activity and their functional profile at the popioid receptor by the following in vitro binding assays.

μ Opioid Receptor Binding Assay:

Radioligand dose-displacement assays use 0.2 nM [³H]-diprenorphine(Perkin Elmer, Boston, Mass.; 50.0 Ci/mmol) with 20 μg membrane protein(recombinant p opioid receptor expressed in CHO-K1 cells (Perkin Elmer,Boston, Mass.) in a final volume of 500 μL binding buffer (10 nM MgCl₂,1 mM EDTA, 5% DMSO, 50 mM Trizma base, pH 7.4). Unlabeled naloxone(Sigma-Aldrich, St. Louis, Mo.) serves as the assay positive control(concentration range 3×10⁻⁷ to 1×10⁻¹³ M). All reactions are performedin 96-deep well polypropylene plates for 2 hours at room temperature.Binding reactions are terminated by rapid filtration onto 96-wellUnifilter GF/C filter plates (Packard, Meriden, Conn.) presoaked in 0.5%polyethylenimine (Sigma-Aldrich, St. Louis, Mo.). Harvesting isperformed using a 96-well tissue harvester (Brandel, Gaithersburg, Md.)followed by three filtration washes with 500 μL icecold binding buffer.Filter plates are subsequently dried at 50° C. for 2-3 hours. 50 μL/wellscintillation cocktail (BetaScint (Perkin Elmer, Boston, Mass.)) isadded and plates are counted in a Packard Top-Count for 1 minute perwell.

Opioid Receptor [³⁵S]GTP-γ-S Binding Functional Assay:

Functional [³⁵S]GTP-γ-S binding assays are conducted by sequentiallymixing the following reagents in the order shown to yield the indicatedfinal concentrations: 0.026 μg/μL μ membrane protein, 10 μg/mL saponin,3 μM guanosine 5′-diphosphate (GDP) (Sigma Chemical Co., St. Louis,Mo.), and 0.20 nM [γ-³⁵S]guanosine 5′-(γ-thio)-triphosphate([³⁵S]GTP-γ-S) (DuPont/New England Nuclear Co., Wilmington, Del.) tobinding buffer (100 mM NaCl, 10 mM MgCl₂, 20 mM HEPES, pH 7.4) on ice.The prepared membrane solution (190 μL/well) is transferred to96-shallow well polypropylene plates containing 10 μL of 20×concentrated stock solutions of compound or appropriate control preparedin dimethylsulfoxide (DMSO). Unlabeled [D-Ala², N-MePhe⁴,Gly⁵-ol]enkephalin (DAMGO) (Sigma-Aldrich, St. Louis, Mo.) serves as theassay positive control for the p functional assay. Plates are incubatedfor 30 minutes at room temperature with shaking. Reactions areterminated by rapid filtration onto 96-well Unifilter GF/B filter plates(Packard, Meriden, Conn.) using a 96-well tissue harvester (Brandel,Gaithersburg, Md.) and followed by three filtration washes with 200 μLice-cold binding buffer (10 nM NaH₂PO₄, 10 mM Na₂HPO₄, pH 7.4). Filterplates are subsequently dried at 50° C. for 2-3 hours. 50 μL/wellscintillation cocktail (BetaScint (Perkin Elmer, Boston, Mass.) is addedand plates are counted in a Packard Top-Count for 1 min/well.

Data analysis: Data from both the binding and functional assays areanalyzed using the curve fitting functions in GraphPad PRISM™, v. 3.0.Data are expressed as mean±S.E.M. The results from the binding assaysare represented as inhibition constants, K_(i) values (the concentrationof a compound that produces half maximal inhibition). The results fromthe functional assays are represented as EC₅₀ values (the effectiveconcentration of a compound that causes 50% of the maximum response).

In vivo Pharmacology: Compounds of of the invention can be tested for invivo distribution to brains after oral administration using, forexample, the following test. Sprague Dawley rats are dosed 10 mg/kgorally with the test compound. The dosing solution is in 25%2-hydroxypropyl beta-cyclodextrin (HPBCD) and the dosing volume is 5mL/kg. One hour after administration, the highest possible volume ofblood is drawn through cardiac puncture. Plasma is separated from thewhole blood by centrifugation and submitted for analysis. Followingbleeding, the whole brains are harvested, briefly rinsed in cold normalsaline, and then snap-frozen in liquid nitrogen. Both plasma and brainsamples are stored at −70° C. prior to analysis.

For analyzing the plasma samples, calibration curves are prepared byspiking known amounts of analytes into commercially available controlrat plasma. 200 μL aliquots of standards and study samples are addedwith 800 μL aqueous solution of internal standard (oxycodone) andextracted on the Cis solid-phase cartridges (96-well format, 3M)according to the following procedure. The cartridges are activated byapplying 500 μL methanol followed by 500 μL of water. Then the samplesare applied and cartridges are washed with 500 μL of water and theneluted with 2×500 μL of 1% formic acid in methanol followed by 2×500 μLof 2% ammonia in methanol. Upon evaporation and reconstitution, thesamples are analyzed by LC/MS/MS. For analyzing the brain samples, studysamples and control brains are homogenized with water in a ratio of 1:10weight per volume. Calibration curves are prepared by spiking knownamounts of the analytes into control brain homogenates. 500 μL aliquotsof standards and study samples are added with 500 μL aqueous solution ofinternal standard (oxycodone) and extracted on the C₁₈ solid-phasecartridges (96-well format, 3M) according to the procedure describedearlier for plasma samples. Upon evaporation and reconstitution, thesamples are analyzed by LC/MS/MS.

Analytes and internal standards are chromatographed on Zorbax ExtendedCis column (4.6×150 mm, 3.5 microns particle size) underwater-acetonitrile gradient conditions (specific gradient for eachanalyte) using procedures known in the art. The effluents are analyzedby MS/MS. The analytes are registered as “daughter” ions of theanalytes' molecular ions on the second quadropole of the instrument. TheMS/MS conditions are optimized for each individual analyte to achievemaximum selectivity and sensitivity.

The concentrations of the unknown samples are calculated based on theparameters of the corresponding calibration curves. The brainconcentrations expressed in “ng per g of tissue” are obtained bymultiplying the corresponding homogenate concentrations by a factor of10 (dilution factor during the homogenation step). The brain-to-bloodratio are calculated as the ratio of the corresponding brain (ng/g) andplasma (ng/mL) concentrations for each individual animal and the meansand standard deviations are calculated for the groups of three.

Compounds of the invention can be tested for their anti-nociceptiveactivity in the formalin model as described in Hunskaar, S., O. B.Fasmer, and K. Hole, J. Neurosci. Methods 14: 69-76 (1985). Male SwissWebster NIH mice (20-30 g; Harlan, San Diego, Calif.) are used in allexperiments. Food is withdrawn on the day of the experiment. Mice areplaced in Plexiglass jars for at least 1 hour to accommodate to theenvironment. Following the accommodation period, mice are weighed andgiven either the compound of interest administered orally in a vehicle,or the appropriate volume of vehicle (10% Tween-80). Thirty minutesafter the oral dosing, mice are injected with formalin (20 μL of 5%formaldehyde solution in saline) into the dorsal surface of the righthind paw. Mice are transferred to the Plexiglass jars and monitored forthe amount of time spent licking or biting the injected paw. Periods oflicking and biting are recorded in 5 minute intervals for 1 hour afterthe formalin injection. All experiments are done in a blinded mannerduring the light cycle. The early phase of the formalin response ismeasured as licking/biting between 0 and 5 minutes, and the late phaseis measured from 15 to 50 minutes. Differences between vehicle and drugtreated groups are analyzed by one-way analysis of variance (ANOVA). A pvalue ≤0.05 is considered significant. Compounds having activity inblocking the acute and second phase of formalin-induced paw-lickingactivity are considered to be efficacious for acute and chronic pain.

Compounds of the invention can be tested for their potential to treatchronic pain (anti-allodynic and anti-hyperalgesic activities) using theChung model of peripheral neuropathy. Male Sprague-Dawley rats weighingbetween 200 and 225 g are anesthetized with halothane (1 to 3% in amixture of 70% air and 30% oxygen) and their body temperature controlledduring anesthesia through use of a homeothermic blanket. A 2-cm dorsalmidline incision is then made at the L5 and L6 level and thepara-vertebral muscle groups retracted bilaterally. L5 and L6 spinalnerves are then exposed, isolated, and tightly ligated with 6-0 silksuture. A sham operation is performed exposing the contralateral L5 andL6 spinal nerves as a negative control.

Tactile Allodynia: Rats are transferred to an elevated testing cage witha wire mesh floor and allowed to acclimate for five to ten minutes. Aseries of Semmes-Weinstein monofilaments are applied to the plantarsurface of the hindpaw to determine the animal's withdrawal threshold.The first filament used possesses a buckling weight of 9.1 gms (0.96 logvalue) and is applied up to five times to see if it elicits a withdrawalresponse. If the animal has a withdrawal response, then the nextlightest filament in the series will be applied up to five times todetermine if it can elicit a response. This procedure is repeated withsubsequent lesser filaments until there is no response and the lightestfilament that elicited a response is recorded. If the animal does nothave a withdrawal response from the initial 9.1 gins filament, thensubsequent filaments of increased weight are applied until a filamentelicits a response and this filament is then recorded. For each animal,three measurements are made at every time point to produce an averagewithdrawal threshold determination. Tests are performed prior to and at1, 2, 4, and 24 hours post drug administration. Tactile allodynia andmechanical hyperalgesia tests are conducted concurrently.

Mechanical Hyperalgesia: Rats are transferred to an elevated testingcage with a wire mesh floor and allowed to acclimate for five to tenminutes. A slightly blunted needle is touched to the plantar surface ofthe hindpaw causing a dimpling of the skin without penetrating the skin.Administration of the needle to control paws typically produces a quickflinching reaction too short to be timed with a stopwatch, andarbitrarily given a withdrawal time of 0.5 second. The operated side pawof neuropathic animals exhibits an exaggerated withdrawal response tothe blunted needle. A maximum withdrawal time of ten seconds is used asa cutoff time. Withdrawal times for both paws of the animals aremeasured three times at each time point with a five-minute recoveryperiod between applications. The three measurements are used to generatean average withdrawal time for each time point. Tactile allodynia andmechanical hyperalgesia tests are conducted concurrently.

The following examples are illustrative, but not limiting, of themethods and compositions of the present invention. Other suitablemodifications and adaptations of the variety of conditions andparameters normally encountered in clinical therapy and which areobvious to those skilled in the art are within the spirit and scope ofthe invention.

PREPARATION EXAMPLES Example 1

Preparation of a compound of Formula IV (oxycodone 2,4-pentanediolketal): Oxycodone free base (2.91 g), p-toluenesulfonic acid monohydrate(2.17 g) and 2,4-pentanediol (5.40 g, mixture of isomers) were stirredin toluene (250 mL) and heated under reflux with a Dean Stark water trapattached. After 3% hours, the mixture was cooled, treated withtriethylamine (5 mL), and washed with water (2×50 mL). The toluenesolution was concentrated under reduced pressure to a clear resin thatsolidified on standing to afford a white solid (Formula I) (3.87 g).FIG. 7 provides the ¹H NMR (d6-DMSO) spectrum of the compound of FormulaIV (oxycodone 2,4-pentanediol ketal).

Using the procedure detailed herein, isomers IVC and IVD were preparedby reacting oxycodone with 2S,4S-pentanediol and 2R,4R-pentanediol,respectively. In addition, using the procedure detailed herein, amixture of isomers IVA and IVB was prepared by reacting oxycodone withmeso-2,4-pentanediol.

Example 2

Preparation of compound of Formula V (oxycodone 1,3-butanediol ketal):Oxycodone free base (1.58 g), p-toluenesulfonic acid (1.19 g) and1,3-butanediol (5.73 g, mixture of isomers) were stirred in toluene (125mL) and heated under reflux with a Dean Stark water trap attached. After5 hours the mixture was cooled and washed with saturated sodiumbicarbonate solution (2×50 mL), then with water (50 ml). The solutionwas dried over magnesium sulfate, filtered, and concentrated underreduced pressure to a colorless resin that solidified on standing toafford a white solid (2.12 g). FIG. 8 provides the ¹H NMR (d6-DMSO)spectrum of the compound of Formula V (oxycodone 1,3-butanediol ketal).

Using the general scheme shown above, the following compounds wereprepared and characterized. Characterization was carried out using anLC/MS system. The LC/MS utilized a Phenomenex Luna C18 column and agradient elution with the first solvent of 90% 2.8 mM ammonium formatein water, 10% methanol, and the second solvent of methanol, at a flowrate of 0.3 mL/min. The molecular weight peaks for each of the compoundsprepared are shown below:

Characterization Retention Product Data time(s) (min) hydrocodone2,4-pentanediol 386.2 (MH+), 17.22, 17.65, 17.99 ketal 387.2 (MH+)oxycodone 2,5-hexanediol 416.20 (MH+), 19.61, 19.98, 21.30, ketal 417.20(MH+) 22.14, 23.36, 24.49 hydrocodone 2,5-hexanediol 400.2 (MH+), 19.61,22.57, 23.51 ketal 401.3 (MH+) hydromorphone 2,4- 372.2 (MH+), 18.24,18.77, 19.23 pentanediol ketal 373.2 (MH+) oxycodone with 1,3- 388.2(MH+), 18.11, 19.24 butanediol (Formula V) 389.2 (MH+) oxycodone 1,2-442.2 (MH+), 25.14, 25.66 cyclohexanedimethanol ketal 443.2 (MH+)Hydrocodone 1,3-propanediol 358.2 (MH+), 17.73 ketal 359.2 (MH+)

Using the general scheme shown above, gram amounts of the followingcompounds were prepared. Additional purification of the compounds wascarried out by recrystallization in ethanol or silica gelchromatography. Characterization was carried out using an LO/MS systemand ¹H NMR spectroscopy. The compounds, quantities prepared, and puritylevels are shown below:

Compound Quantity (g) % Purity (LCMS) Oxycodone 2,4-pentanediol ketal5.17 g 99.77 (mixed isomers) Oxycodone 2R,4R-pentanediol ketal 0.80 g99.71 Oxycodone 2S,4S-pentanediol ketal 6.82  99.82 Hydrocodone2,4-pentanediol ketal 2.14  99.50 (mixed isomers) Hydrocodone2R,4R-pentanediol ketal 6.20  98.31 Hydrocodone 2S,4S-pentanediol ketal6.58  99.36 Hydromorphone 2,4-pentanediol ketal 1.00  99.25Hydrolysis Studies with Simulated Gastric Fluid and 0.1 N HCl

Example 3

A mixture of isomers of oxycodone 2,4-pentanediol ketal along withunreacted oxycodone at a concentration of 2 mg/ml was subjected tohydrolysis in USP Simulated Gastric Fluid (SGF) (0.2% NaCl and 0.32%pepsin in 0.084 N HCl) at 37° C., with analysis of the hydrolyzedoxycodone conducted by LC/MS. Results from the hydrolysis are shown inTable 1a and illustrated in FIG. 1 .

As a comparison, a mixture of isomers of oxycodone 2,4-pentanediol ketalalong with unreacted oxycodone was dissolved in 0.1 N HCl at aconcentration of 2 mg/ml and heated to 37° C. The course of thehydrolysis was monitored by LC/MS. Results from the hydrolysis are shownin Table 1b and illustrated in FIG. 1 .

TABLE 1a Simulated Gastric Fluid Ketal Ketal Ketal Ketal Hours OxycodoneA B C D 0 7.3 26.6 10.3 38.4 17.3 0.58 19.9 25.7 9.8 32.8 11.7 1.25 35.325.3 10.4 25.2 3.8 2 43 24.2 9.7 21 1.6 3 51 23.7 10.2 14.2 0.85 4 58.722.7 9.1 9.4 0

TABLE 1b 0.1N HCl Ketal Ketal Ketal Ketal Hours Oxycodone A B C D 0 11.424.7 10.7 35.8 17.3 0.583 25.5 25.9 10.6 29.2 8.6 1.167 33 25.6 10.7 264.8 1.75 44 25 7.8 20.6 2.6 2.33 47.6 25.9 8.3 17.7 1.5 2.92 50.9 24.88.7 15 0.7 4 56.8 23.7 9.2 10.3 0

The results show that the hydrolysis rates of the isomers are similar in0.1 N HCl and SGF, indicating that the pepsin enzyme present in the SGFhas little effect on the hydrolysis rate.

Example 4

Hydrocodone 2,4-pentanediol ketal at a concentration of 1 mg/ml wassubjected to hydrolysis in USP Simulated Gastric Fluid (SGF) (0.2% NaCland 0.32% pepsin in 0.084 N HCl) at 37° C., with analysis of thehydrolyzed hydrocodone conducted by LC/MS. Results from this hydrolysisare shown in Table 2a and illustrated in FIG. 2 .

As a comparison, a mixture of four stereoisomers of hydrocodone2,4-pentanediol ketal along with unreacted hydrocodone was dissolved in0.1 N HCl at a concentration of 1 mg/ml and heated to 37° C. The courseof the hydrolysis was monitored by LC/MS. Results from this hydrolysisare shown in Table 2b and illustrated in FIG. 2 . Two of thestereoisomers designated as Ketal A+B were not resolved under the LC/MSconditions employed.

TABLE 2a SGF % Ketal % Ketal % Ketal Hours Hydrocodone A + B C D 0 131.4 38.3 29.3 0.58 33.7 26.4 32.3 7.5 1.25 45.9 25.8 25.6 2.6 2 48.1 2823 0 3 55.1 28.9 15.9 0 4 58.3 29 12.7 0

TABLE 2b 0.1N HCl % Ketal % Ketal % Ketal Hours Hydrocodone A + B C D 03 30.1 37.3 29.6 0.58 29.2 30.2 32.3 8.3 1.25 41.1 29.4 28 1.5 2 41.5 3820.6 0 3 53.4 32.5 14.3 0 4 59.4 31.3 9.3 0

The results show that the hydrolysis rates of the isomers are similar in0.1 N HCl and SGF, indicating that the pepsin enzyme present in the SGFhas little effect on the hydrolysis rate.

Example 5

A mixture of isomers of hydromorphone 2,4-pentanediol ketal along withunreacted hydromorphone at a concentration of 1 mg/ml was subjected tohydrolysis in 0.1 N HCl at 37° C., with analysis of the hydrolyzedhydromorphone conducted by LC/MS. Results from the hydrolysis are shownin Table 3 and illustrated in FIG. 3 . The % increase in hydromorphonerepresents the hydromorphone released from the hydrolysis of the ketals.

TABLE 3 % Increase % % % % % Hydro- in hydro- Ketal Ketal Ketal KetalHours morphone morphone A B C D 0 63.3 0 3.6 5 8.7 19.1 0.58 72.5 9.23.1 5 8.1 11.2 1.25 75.4 12.1 3 5.1 8  8.5 2 78.8 15.5 3.2 5.6 6.7  5.63.15 83 19.7 2.9 5.8 5.4  2.9 4 85 21.7 2.3 5.6 4.9  2.1

As shown in Table 3 and FIG. 3 , Ketal D showed near complete hydrolysisin 4 hours at 0.1 N HCl at 37° C. In comparison, ketals A, B, and Chydrolyzed more slowly and did not hydrolyze completely within 4 hoursin 0.1 N HCl at 37° C.

Example 6

A mixture of oxycodone cis 1,2-cyclohexancdimethanol ketals was preparedas described above and subjected to hydrolysis in 0.1 N HCl at 37° C. ata concentration of 1 mg/ml. Results from the analysis are shown below inTable 4 and FIG. 4 .

TABLE 4 Hours % Oxycodone % Ketal A % Ketal B 0 27.2 32.2 39 0.56 28.129.5 39.7 1.25 33.8 28.5 36.3 2 37.4 27.6 32.7 4.45 56.4 20.2 23.4

Example 7

Hydrocodone 1,3-propanediol ketal was prepared according to the generalprocedures above and tested for hydrolysis in 0.1 N HCl at 37° C. at aconcentration of 1 mg/ml. Results from the analysis are shown below inTable 5 and FIG. 5 .

TABLE 5 Hours % hydrocodone % Ketal 0 6.9 93.1 0.57 34.3 65.7 1.25 47.752.3 2 58.2 41.8 3 67.8 32.8 4 74.4 25.6

Example 8

Hydrocodone 2S,5S-hexanediol ketal and hydrocodone 2R,5R-hexanediolketal were individually prepared and separately tested for hydrolysis in0.1 N HCl at 37° C. at concentrations of 1 mg/ml each. The hydrolysisrates are shown below in Tables 6a and 6b. The hydrolysis of the ketalsand corresponding release of hydrocodone are shown in FIG. 6 . Thedashed lines represent 2S,5S hydrocodone hexanediol ketal and thereleased hydrocodone. The solid lines represent hydrocodone 2R,5Rhexanediol ketal and the hydrolyzed hydrocodone.

TABLE 6a Hours Hydrocodone 2S,5S ketal 0 18.02 81.98 0.5 47.82 52.181.25 64.89 35.11 2 89.81 10.19 3 95.71 4.29 4 98 2

TABLE 6b Hours Hydrocodone 2R,5R ketal 0 26.1 73.88 0.5 65.4 34.6 1.2588.6 11.37 2 97.3 2.67 3 100 0 4 100 0

Example 9

Oxycodone 2,4-pentanediol ketal (1.1 mg, mixture of isomers) was stirredin fresh EDTA stabilized blood plasma for 5 minutes. The mixture wasfiltered (0.45 micron PTFE) and analyzed by LC/MS. The sample was heldat 37° C. for four hours, filtered (0.45 micron PTFE) and analyzed byLC/MS. The results showed that approximately 6% of the ketal hydrolyzedto oxycodone over the four hour period.

Hydrocodone 2,4-pentanediol ketal (1.1 mg, mixture of isomers) wasstirred in fresh EDTA stabilized blood plasma for 5 minutes. The mixturewas filtered (0.45 micron PTFE) and analyzed by LC/MS. The sample washeld at 37° C. for four hours, filtered (0.45 micron PTFE) and analyzedby LCMS. The results showed that approximately 0.2% of the ketalhydrolyzed to hydrocodone over the four hour period.

The results therefore indicate that an abuser will be less likely toabuse the opioid ketal compounds of the invention by parenteraladministration (i.e., inhalation or injection) of the drug to achieverapid euphoria.

Example 10

The following opioid ketals having five membered ketal rings weresynthesized and tested for hydrolysis in 0.1 N HCl at 37° C. and/or SGF,respectively.

Hydrolysis in 0.1N HCl Compound at 37° C. Hydrolysis in SGF

14.3% hydrolyzed in 20 hours Not tested

1% hydrolyzed in four hours Trace hydrolysis in 6.75 hours

2.5% hydrolyzed in four hours ~2% hydrolyzed in 6.75 hours

6.6% hydrolyzed in 19 hours Not tested

Example 11

Improved Synthesis of Compounds of the Invention Using a Small Excess ofDial

An exemplary preparation of a compound of Formula I: A solution ofoxycodone (1 equivalent), 2R,4R-pentanediol (1.1 equivalent),p-toluenesulfonic acid monohydrate (1.5 equivalent), and toluene wasbrought to reflux while under a stream of nitrogen. Water wasazeotropically removed into a Dean Stark trap. The solution was refluxedfor a total of 22.5 hours with aliquots for LCMS taken at 3.5, 6 and22.5 hours. Approximately 25% of the starting oxycodone remainedunconsumed after 22.5 hours. Minimal impurities were present in thefinal reaction mixture.

Example 12

Hydrolysis Studies of Formula IV (Oxycodone 2,4-Pentanediol Ketal) in0.1 N HCl at 37° C.

A mixture of unreacted oxycodone and four isomers of Formula IV(IVA-IVD) was dissolved in 0.1 N HCl at a total concentration of 1 mg/mland heated to 37° C. The course of the hydrolysis was monitored byLC/MS. Results from the hydrolysis are shown in Table 7 and illustratedin FIG. 9 .

TABLE 7 Hours % Oxycodone % IVA % IVB % IVC % IVD 0 11.4 24.7 10.7 35.817.3 0.583 25.5 25.9 10.6 29.2 8.6 1.167 33 25.6 10.7 26 4.8 1.75 44 257.8 20.6 2.6 2.33 47.6 25.9 8.3 17.7 1.5 2.92 50.9 24.8 8.7 15 0.7 456.8 23.7 9.2 10.3 0 6.5 66 19.8 10 4 0 9.75 72.6 15.6 10.2 1.5 0 13.7579.7 9.9 10.4 0 0 25 86.4 4.3 9.3 0 0

Isomers IVC and IVD were individually prepared and separately tested fortheir hydrolysis in 0.1 N HCl at 37° C. at concentrations of 1 mg/mleach. Results from the hydrolysis were normalized, and are presented inTables 8a and 8b and illustrated in FIG. 10 . The dashed lines representoxycodone 2S,5S pentanediol ketal and the hydrolyzed oxycodone. Thesolid lines represent oxycodone 21R,51R pentanediol ketal and thehydrolyzed oxycodone.

TABLE 8a % IVD (Oxycodone Hours % Oxycodone 2R,4R-pentanediol ketal) 00.8 99.8 0.17 26.9 70 0.33 55.2 44.8 1 89.2 10.8 2 98 2

TABLE 8b % IVC (Oxycodone Hours Oxycodone 2S,4S-pentanediol ketal) 0 1.398.7 0.75 28.5 71.5 1.5 46 54 3.33 81.2 18.8 6 95.3 4.7 8 97.9 2.1

A mixture of unreacted oxycodone and four isomers of Formula V (Va-Vd)was dissolved in 0.1 N HC at a concentration of 1 mg/m2 and heated to37° C. The course of the hydrolysis was monitored by LC/MS. Results fromthe hydrolysis are shown in Table 9 and illustrated in FIG. 11 .

TABLE 9 Hours % Oxycodone % Va* % Vb* % Vc* + Vd* 0 1 26.1 25.3 40.10.58 14.1 21.7 23.4 37.3 1.17 20.8 18.7 21.8 35.5 2.5 32.8 13.7 20.129.7 5 49 6.6 17.7 24.9 10 69.3 0.2 11.3 17.3 25 87.7 0.7 3.2 7.8 *Thestereochemistry of each of the isomers Va-Vd is to be determined.

Example 13

Hydrolysis Study: 5% Acetic Acid at 100° C.

A mixture of unreacted oxycodone and four isomers of Formula IV(IVA-IVD) was dissolved in 5% acetic acid at a concentration of 1 mg/mland heated to 100° C. The course of the hydrolysis was monitored byLC/MS. Results from the hydrolysis are shown in Table 4 and illustratedin FIG. 12 .

TABLE 10 Hours % Oxycodone % IVA % IVB % IVC % IVD 0 10.3 24 10.9 36.217.6 0.5 55.8 21.1 8.7 12.8 1.5 1 69.6 15.8 9.7 5.9 0 2 83.9 6 9.2 0.9 04.35 87.9 3.1 9 0 0 10 95.2 0 4.8 0 0

A mixture of unreacted oxycodone and four isomers of Formula V wasdissolved in 5% acetic acid at a concentration of 1 mg/nil and heated to100° C. The course of the hydrolysis was monitored by LC/MS. Resultsfrom the hydrolysis are shown in Table 11 and illustrated in FIG. 13 .

TABLE 11 Hours % Oxycodone % Va* % Vb* % Vc* + Vd* 0 1 26.1 25.3 40.10.33 31.8 17.3 19 27.4 0.67 46.4 13 15.3 21.9 1 56.5 7.8 11.9 19.3 272.8 3.1 4.7 11.8 4 85.4 2.6 1 4.1 *The stereochemistry of each of theisomers Va-Vd is to be determined.

Example 14

A mixture of oxycodone 3,5-octanediol ketals was prepared as describedabove and subjected to hydrolysis in 0.1 N HCl at 37° C. at aconcentration of 1 mg/ml. Results from the analysis are shown below inTable 12 and FIG. 14 . The lines representing the peaks of Ketal a andKetal b are mixtures of isomers that were unresolved under the LCMSconditions used.

TABLE 12 Hours % Oxycodone % Ketal a % Ketal b 0 0.3 27 70 0.33 12.126.6 59.6 1 26.5 27.2 44.7 2 40.7 27.2 30.9 4 56.1 28.1 15.7

Example 15

Ketal Hydrolysis at Varying pH

Hydrocodone 2R,4R-pentanediol ketal was hydrolyzed at 37° C. in variouspH buffers at a concentration of 1 mg/ml. The data from the hydrolysisis shown in Table 13a below and in FIG. 15 . The data show thathydrolysis of the ketal to generate the parent hydrocodone is fastest atpH 1.

TABLE 13a Hours pH 1 pH 1.5 pH 2 pH 2.5 pH 3 0 0 0 0 0 0 0.33 50 30.68.3 0 0 1 90 59.4 21.9 0 0 2 99.8 85.1 37.7 15.9 5.9 4 100 98.2 58.226.4 12.7 Hours pH 4 pH 5 pH 7 pH 12 0 0.33 1 2 4 1.3* 0.15* 0.01* 0.01**Hydrolysis times estimated from longer hydrolysis times

Oxycodone 2R,4R-pentanediol ketal was hydrolyzed at 37° C. in various pHbuffers at a concentration of 1 mg/ml. The data from the hydrolysis isshown in Table 13b below and in FIG. 16 . The data show that hydrolysisof the ketal to generate the parent hydrocodone is fastest at pH 1.

TABLE 13b Hours pH 1 pH 1.5 pH 2 pH 2.5 pH 3 0 0 0 0 0 0 0.33 55.2 14.94.6 0 0 1 89.2 34.4 13.3 0 0 2 98 51.9 24.2 8.4 3.4 4 100 80.4 40.9 14.76.4

Example 16

A mixture of four isomers of Formula IV (IVA-IVD) at a concentration of1 mg/ml was tested for hydrolysis in the soft drink Coca Cola®, or in apH 4 buffer, or in a pH 7 buffer. As shown in Table 14 below, themixture showed very low degree of hydrolysis after 3 days under each ofthe tested conditions.

TABLE 14 Hydrolysis to Solvent Temperature Oxycodone Coca Cola ® 23° C.5% pH 4 Buffer 37° C. 4% pH 7 Buffer 37° C. 0%

Having now fully described this invention, it will be understood bythose of ordinary skill in the art that the same can be performed withina wide and equivalent range of conditions, formulations and otherparameters without affecting the scope of the invention or anyembodiment thereof.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with a true scope and spiritof the invention being indicated by the following claims.

All patents and publications cited herein are fully incorporated byreference herein in their entirety.

What is claimed is:
 1. A method of treating or ameliorating pain in amammal identified as in need thereof through an oxycodone therapy,comprising orally administering to the mammal an effective amount of oneor more compounds of Formula II, III, or V:

or a pharmaceutically acceptable salt thereof, wherein the carbon atomlabeled * or ** is in R or S configuration, and wherein the methodprovides the mammal an extended release of the oxycodone, as compared toan oral administration of the oxycodone or a pharmaceutically acceptablesalt thereof in an immediate release form to the mammal.
 2. The methodof claim 1, wherein the pain is acute pain or chronic pain.
 3. Themethod of claim 1, wherein the method comprises the administration of aneffective amount of a compound of Formula V selected from the groupconsisting of

or a pharmaceutically acceptable salt thereof.
 4. The method of claim 3,wherein the method comprises administering to the mammal a mixture oftwo or more compounds of Formula V or pharmaceutically acceptable saltsthereof.
 5. The method of claim 3, wherein the method comprisesadministering to the mammal a mixture comprising compounds VA, VB, VC,and VD, or pharmaceutically acceptable salts thereof.
 6. The method ofclaim 1, wherein the method comprises the administration of an effectiveamount of one or more compounds of Formula II or Formula III:

or a pharmaceutically acceptable salt thereof.
 7. The method of claim 6,wherein the method comprises the administration of a mixture comprisingtwo or more stereoisomers of a compound of Formula III, orpharmaceutically acceptable salts thereof.
 8. The method of claim 1,wherein the method reduces an abuse or misuse potential of the oxycodonetherapy.
 9. The method of claim 1, wherein the method reduces euphoriceffects of the oxycodone therapy.
 10. The method of claim 1, wherein thecompound of Formula II, III, or V is administered at a dose of from 0.1to 5 mg/kg, or a molar equivalent amount of a pharmaceuticallyacceptable salt thereof, based on the body weight of the mammal.
 11. Themethod of claim 1, wherein the compound of Formula II, III, or V, or apharmaceutically acceptable salt thereof, is administered as part of apharmaceutical composition comprising between 5 mg and 320 mg of thecompound of Formula II, III, or V or a molar equivalent of thepharmaceutically acceptable salt thereof.